Wang Shao-Bo, Ji Yun-Hai, Wu Hu-Bing, Wang Quan-Shi, Zhou Wen-Lan, Lv Liang, Shou Tao, Hu Jing
aPET/CT Center, the First People's Hospital of Yunnan Province, Kunming bNanFang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou cDepartment of Radiology dDepartment of Medical Oncology, The First People's Hospital of Yunnan Province, Kunming, China.
Medicine (Baltimore). 2017 Jan;96(2):e5867. doi: 10.1097/MD.0000000000005867.
Tuberculous peritonitis (TBP) mimics peritoneal carcinomatosis (PC). We aimed to investigate the discriminative use of PET/CT findings in the parietal peritoneum.
Parietal peritoneal PET/CT findings from 76 patients with TBP (n = 25) and PC (n = 51) were retrospectively reviewed. The lesion locations were noted as right subdiaphragmatic, left subdiaphragmatic, right paracolic gutters, left paracolic gutters, and pelvic regions. The distribution characteristic consisted of a dominant distribution in the pelvic and/or right subdiaphragmatic region (susceptible area for peritoneal implantation, SAPI) (SAPI distribution), a dominant distribution in the remaining regions (less-susceptible area for peritoneal implantation, LSAPI) (LSAPI distribution), or a uniform distribution. PET morphological patterns were classified as F18-fluorodeoxyglucose (F-FDG) uptake in a long beaded line (string-of-beads F-FDG uptake) or in a cluster (clustered F-FDG uptake) or focal F-FDG uptake. CT patterns included smooth uniform thickening, irregular thickening, or nodules.
More common findings in the parietal peritoneum corresponding to TBP as opposed to PC were (a) ≥4 involved regions (80.0% vs 19.6%), (b) uniform distribution (72.0% vs 5.9%), (c) string-of-beads F-FDG uptake (76.0% vs 7.8%), and (d) smooth uniform thickening (60.0% vs 7.8%) (all P < 0.001), whereas more frequent findings in PC compared with TBP were (a) SAPI distribution (78.4% vs 28.0%), (b) clustered F-FDG uptake (56.9% vs 20.0%), (c) focal F-FDG uptake (21.6% vs 4.0%), (d) irregular thickening (51.0% vs 12.0%), and (e) nodules (21.6% vs 4.0%) (P < 0.001, P < 0.05, P > 0.05, P < 0.05, P > 0.05, respectively).
Our data show that PET/CT findings in the parietal peritoneum are useful for differentiating between TBP and PC.
结核性腹膜炎（TBP）可模拟腹膜癌病（PC）。我们旨在研究PET/CT在壁腹膜检查结果中的鉴别应用。
回顾性分析76例TBP患者（n = 25）和PC患者（n = 51）的壁腹膜PET/CT检查结果。病变位置记录为右膈下、左膈下、右结肠旁沟、左结肠旁沟和盆腔区域。分布特征包括在盆腔和/或右膈下区域（腹膜种植易感区域，SAPI）占主导的分布（SAPI分布）、在其余区域占主导的分布（腹膜种植不易感区域，LSAPI）（LSAPI分布）或均匀分布。PET形态学模式分为长串珠状18F-氟脱氧葡萄糖（F-FDG）摄取（串珠状F-FDG摄取）、簇状F-FDG摄取或局灶性F-FDG摄取。CT模式包括光滑均匀增厚、不规则增厚或结节。
与PC相比，TBP在壁腹膜中的常见表现为：（a）累及区域≥4个（80.0%对19.6%），（b）均匀分布（72.0%对5.9%），（c）串珠状F-FDG摄取（76.0%对7.8%），（d）光滑均匀增厚（60.0%对7.8%）（所有P < 0.001）；而与TBP相比，PC中更常见的表现为：（a）SAPI分布（78.4%对28.0%），（b）簇状F-FDG摄取（56.9%对20.0%），（c）局灶性F-FDG摄取（21.6%对4.0%），（d）不规则增厚（51.0%对12.0%），（e）结节（21.6%对4.0%）（分别为P < 0.001、P < 0.05、P > 0.05、P < 0.05、P > 0.05）。
我们的数据表明，壁腹膜的PET/CT检查结果有助于鉴别TBP和PC。
