Jacquet P, Jelinek J S, Steves M A, Sugarbaker P H
Chirurgie Abdominole et generale, Centre Hospital University Liege, Belgium.
Cancer. 1993 Sep 1;72(5):1631-6. doi: 10.1002/1097-0142(19930901)72:5<1631::aid-cncr2820720523>3.0.co;2-i.
Radiologic tests to determine the size and location of cancer on peritoneal surfaces are needed for patient management and for clinical research activity.
Computed tomography (CT) of the abdomen and pelvis were obtained on 45 patients with a diagnosis of peritoneal carcinomatosis before implementation of a complete exploratory laparotomy with biopsy or resection of all tissues suspicious of malignancy. CT findings and surgical findings were recorded and the data analyzed by dividing the abdomen into 9 regions or into 15 anatomic sites.
In an overall patient analysis, the sensitivity was 79%. In the nine different abdominal regions, sensitivity was greater than 80% in the right flank, left flank, and right lower and left lower abdominal regions. Sensitivity was lowest in the pelvis (60%). Negative predictive value in the pelvis was 20%. The volume of tumor present within an abdominal region or anatomic site greatly influenced the sensitivity. A sensitivity of only 28% was recorded when tumor nodules were less than 0.5 cm in thickness. This increased to 90% when nodule thickness was greater than 5 cm.
CT is not a reliable diagnostic test for low volume tumor on peritoneal surfaces, and the greatest inaccuracies were recorded in the pelvis. Its diagnostic value increased as tumor volume increased.
为了患者管理和临床研究活动，需要进行放射学检查以确定腹膜表面癌症的大小和位置。
在对45例诊断为腹膜癌的患者进行全面的剖腹探查并对所有可疑恶性组织进行活检或切除之前，对其进行腹部和骨盆的计算机断层扫描（CT）。记录CT结果和手术结果，并通过将腹部划分为9个区域或15个解剖部位来分析数据。
在总体患者分析中，敏感性为79%。在九个不同的腹部区域中，右侧腹、左侧腹以及右下腹部和左下腹部区域的敏感性大于80%。骨盆区域的敏感性最低（60%）。骨盆区域的阴性预测值为20%。腹部区域或解剖部位内存在的肿瘤体积对敏感性有很大影响。当肿瘤结节厚度小于0.5 cm时，敏感性仅为28%。当结节厚度大于5 cm时，敏感性增至90%。
CT对于腹膜表面小体积肿瘤不是一种可靠的诊断检查，且在骨盆区域记录到的误差最大。其诊断价值随着肿瘤体积的增加而增加。
