Zafar Ibtesam, Majeed Ayesha Isani, Asad Muhammad Waseem, Khan Amir, Bhutta Muzammil Rasheed, Naeem Khan Muhammad Nasir
Radiology, Pakistan Institute of Medical Sciences, Islamabad, PAK.
Gastroenterology and Hepatology, Pakistan Institute of Medical Sciences, Islamabad, PAK.
Cureus. 2021 Dec 7;13(12):e20254. doi: 10.7759/cureus.20254. eCollection 2021 Dec.
Objective The goal of this research was to define the diagnostic precision of CT signs to distinguish malignant ascites from cirrhotic ascites. Ascitic fluid cytology was kept as the gold standard. Study design This research was a prospective cross-sectional study. Place and duration of the study Participants' recruitment started on July 15, 2021, and the whole study lasted about three months till October 15, 2021, at the Radiology Department of Pakistan Institute of Medical Sciences, Islamabad. Patients and methods A total of 80 patients were included in the research and divided into two groups grounded on the cirrhotic or malignant etiology of the ascites based on their fluid cytology. Ascites volume, relative spread between the lesser sac and greater peritoneal cavity, the wall thickness of gallbladder, density of ascites, parietal peritoneum thickness and degree of its enhancement, and presence of septa and loculations were some of the major CT signs studied. Results The average age of patients included in this study was 36.2 ± 6.67 years (range 29-49 years). Of the 80 patients, 50 (62.5 %) were men, and 30 (37.5 %) were women. CT signs associated with the malignant ascites reported in this study were fluid present in the lesser sac (p = 0.03), peritoneal thickening and degree of its enhancement (p = 0.05), increased ascites density (p= 0.001), and presence of septa and loculations (63.6 % of malignant ascites). However, gallbladder wall thickness did not show any variation between both groups. Conclusion We conclude that in the diagnosis of malignant ascites, CT scan imaging can play a vital role. This research approves and testifies the benefits of indirect signs such as the spread of ascites, increased density of ascites, thickening and enhancement of parietal peritoneum, and ascitic fluid complexity in pointing out malignancy as a cause of ascites.
目的 本研究的目的是确定CT征象对鉴别恶性腹水和肝硬化腹水的诊断准确性。腹水细胞学检查作为金标准。
研究设计 本研究为前瞻性横断面研究。
研究地点和时间 研究对象招募于2021年7月15日开始，整个研究持续约三个月，至2021年10月15日结束，在伊斯兰堡巴基斯坦医学科学研究所放射科进行。
患者和方法 本研究共纳入80例患者，根据腹水的细胞学检查结果，基于肝硬化或恶性病因将其分为两组。研究的主要CT征象包括腹水容量、小网膜囊与大腹膜腔之间的相对扩散、胆囊壁厚度、腹水密度、壁层腹膜厚度及其强化程度，以及隔和分隔的存在情况。
结果 本研究纳入患者的平均年龄为36.2±6.67岁（范围29 - 49岁）。80例患者中，50例（62.5%）为男性，30例（37.5%）为女性。本研究报道的与恶性腹水相关的CT征象有小网膜囊内有液体（p = 0.03）、腹膜增厚及其强化程度（p = 0.05）、腹水密度增加（p = 0.001）以及隔和分隔的存在（恶性腹水中63.6%）。然而，两组之间胆囊壁厚度无差异。
结论 我们得出结论，在恶性腹水的诊断中，CT扫描成像可发挥重要作用。本研究证实并验证了间接征象如腹水扩散、腹水密度增加、壁层腹膜增厚和强化以及腹水复杂性在指出恶性肿瘤为腹水病因方面的益处。
