Department of Ultrasound, Chinese People's Liberation Army General Hospital, Beijing, China.
J Ultrasound Med. 2013 Sep;32(9):1565-70. doi: 10.7863/ultra.32.9.1565.
The purpose of this study was to analyze the sonographic features of pseudomyxoma peritonei and the ability of preoperative sonography to assess the pathologic grades of this disease.
Nineteen patients with pseudomyxoma peritonei who underwent preoperative sonographic examinations were included (9 male and 10 female; age range, 31-70 years). Four patients presented with disseminated peritoneal adenomucinosis, 7 with peritoneal mucinous carcinomatosis with intermediate or discordant features (intermediate-grade disease), and 8 with peritoneal mucinous carcinomatosis. The sonographic characteristics, clinical features, and serum tumor marker levels were recorded and compared among the 3 grades.
Clinical symptoms and carcinoembryonic antigen, cancer antigen 125 (CA-125), CA-19-9, CA-724, and CA-153 levels were not significantly different among the 3 pathologic grades (P > .05). Ascites, scalloping of the visceral margin, invasive parenchymal nodules, and peritoneal masses were detected in all grades. Disseminated peritoneal adenomucinosis occurred without the finding of an omental cake. The presence of enlarged lymph nodes was more common in peritoneal mucinous carcinomatosis. The diagnosis of pseudomyxoma peritonei was made by preoperative sonography in 1 case. Four cases were diagnosed as ovarian mucinous cystadenoma with rupture. One case was diagnosed as a mucinous appendiceal cyst. Four cases were diagnosed as ascites or encapsulated effusion. One case was misdiagnosed as lymphoma. The others were diagnosed as celiac masses.
Preoperative sonography can be used to diagnose pseudomyxoma peritonei as long as radiologists are familiar with the imaging features. Although there are overlaps in the sonographic findings among the different grades, some features may aid in separating them.
本研究旨在分析腹膜假性黏液瘤的超声特征及术前超声评估该病病理分级的能力。
本研究纳入 19 例腹膜假性黏液瘤患者，均接受术前超声检查（男 9 例，女 10 例；年龄 31~70 岁）。4 例患者表现为弥漫性腹膜黏液腺瘤病，7 例患者表现为具有中等或不一致特征的腹膜黏液性癌（中等级别疾病），8 例患者表现为腹膜黏液性癌。记录并比较 3 个级别患者的超声特征、临床特征和血清肿瘤标志物水平。
3 个病理分级的临床症状、癌胚抗原、糖类抗原 125（CA-125）、CA-19-9、CA-724 和 CA-153 水平差异均无统计学意义（P＞0.05）。所有分级均发现腹水、内脏边缘扇贝样改变、侵袭性实质结节和腹膜肿块。弥漫性腹膜黏液腺瘤病没有网膜饼样表现。腹膜黏液性癌更常见增大的淋巴结。术前超声诊断腹膜假性黏液瘤 1 例。诊断为卵巢黏液性囊腺瘤破裂 4 例。诊断为阑尾黏液囊肿 1 例。诊断为腹水或包裹性积液 4 例。误诊为淋巴瘤 1 例。其他病例诊断为腹腔肿块。
只要放射科医生熟悉其影像学特征，术前超声检查可用于诊断腹膜假性黏液瘤。尽管不同分级之间存在超声表现重叠，但一些特征可能有助于区分它们。
