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腹部皮肤恶性黑色素瘤的 CT、MRI 和 PET/CT 表现:肿瘤特异性治疗时代的现有概念综述。

CT, MRI and PET/CT features of abdominal manifestations of cutaneous melanoma: a review of current concepts in the era of tumor-specific therapies.

机构信息

Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.

Université de Paris, Descartes-Paris 5, rue de l'Ecole de Médecine, F-75006, Paris, France.

出版信息

Abdom Radiol (NY). 2021 May;46(5):2219-2235. doi: 10.1007/s00261-020-02837-4. Epub 2020 Nov 2.

Abstract

Abdominal manifestations in patients with cutaneous melanoma include involvement due to metastatic spread and immune checkpoint inhibitor induced adverse events. The purpose of this review is to provide a critical overview of abdominal manifestations in patients with cutaneous melanoma and highlight the current imaging challenges in the era of tumor-specific therapies. Immune checkpoint inhibitors represent a treatment with demonstrated efficacy in the treatment of advanced cutaneous melanoma but are associated with several abdominal adverse events that must be recognized. CT has a role in the identification of colitis, enteritis and pancreatitis, whereas MRI has an important role in the diagnosis of autoimmune pancreatitis. Current evidence demonstrates that MRI should be the preferred imaging technique for the detection and characterization of hepatic and splenic metastases from cutaneous melanoma. The role of F-FDG-PET/CT should be further evaluated but current literature suggests an efficacy in the detection of pancreatic metastases not seen on CT and MRI.

摘要

皮肤黑色素瘤患者的腹部表现包括转移性疾病和免疫检查点抑制剂相关不良事件。本综述的目的是对皮肤黑色素瘤患者的腹部表现进行批判性概述,并强调在肿瘤特异性治疗时代的当前影像学挑战。免疫检查点抑制剂在治疗晚期皮肤黑色素瘤方面具有显著疗效,但也与多种必须识别的腹部不良事件相关。CT 有助于识别结肠炎、肠炎和胰腺炎,而 MRI 在诊断自身免疫性胰腺炎方面具有重要作用。现有证据表明,MRI 应是检测和特征分析皮肤黑色素瘤肝和脾转移的首选影像学技术。F-FDG-PET/CT 的作用需要进一步评估,但现有文献表明其在检测 CT 和 MRI 未发现的胰腺转移方面具有疗效。

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