Halvorsen R A, Panushka C, Oakley G J, Letourneau J G, Adcock L L
Department of Radiology, University of Minnesota, Minneapolis 55455.
AJR Am J Roentgenol. 1991 Jul;157(1):37-40. doi: 10.2214/ajr.157.1.2048534.
The preoperative detection of peritoneal metastases from gynecologic malignancies is difficult; in particular, CT often fails to detect peritoneal implants. This study was designed to determine if the administration of intraperitoneal iodinated contrast media would increase the CT detection of such peritoneal metastases. Prospectively, both standard and intraperitoneal contrast-enhanced CT studies of the abdomen and pelvis were performed in 16 patients with suspected gynecologic tumors. All patients then underwent operative staging, with the location and number of metastases documented. The intraperitoneal enhanced CT studies were more sensitive in the detection of peritoneal metastases than standard CT examinations. Whereas routine CT detected peritoneal metastases in seven (64%) of 11 patients with surgically proved implants, the intraperitoneal enhanced CT studies detected peritoneal metastases in all 11 patients. Depending on the specific intraperitoneal compartments involved, the sensitivity of intraperitoneal enhanced CT in the detection of peritoneal metastases was two- to fourfold greater than that of standard CT examinations. Our results suggest that intraperitoneal enhanced CT is superior to standard CT in the detection of peritoneal metastases.
妇科恶性肿瘤腹膜转移的术前检测颇具难度；尤其是CT常常无法检测到腹膜种植灶。本研究旨在确定腹腔内注射碘化造影剂是否会提高CT对这类腹膜转移的检测率。前瞻性地对16例疑似妇科肿瘤患者进行了腹部和盆腔的标准CT及腹腔内对比增强CT检查。所有患者随后均接受了手术分期，并记录转移灶的位置和数量。腹腔内对比增强CT检查在检测腹膜转移方面比标准CT检查更敏感。在11例经手术证实存在种植灶的患者中，常规CT检测到7例（64%）腹膜转移，而腹腔内对比增强CT检查在所有11例患者中均检测到了腹膜转移。根据所涉及的具体腹腔间隙，腹腔内对比增强CT检测腹膜转移的敏感性比标准CT检查高两到四倍。我们的结果表明，腹腔内对比增强CT在检测腹膜转移方面优于标准CT。
