Glajchen N, Shapiro R D, Stock R G, Stone N N, Ramos R
Department of Radiology, The Mount Sinai Hospital and Medical School, New York, NY 10029, USA.
AJR Am J Roentgenol. 1996 May;166(5):1165-8. doi: 10.2214/ajr.166.5.8615263.
The purpose of this paper is to describe the CT findings in patients undergoing transperineal sonographically guided radioactive seed implantation with and without laparoscopic lymph node dissection for treatment of carcinoma of the prostate gland.
Ninety-six CT scans of the pelvis were retrospectively reviewed in patients who had undergone radioactive seed implantation of the prostate gland. The CT readings were correlated with the type of procedure each patient had and the pathologic results of laparoscopic lymph node dissection.
Of 73 patients who underwent laparoscopic lymph node dissection, 42 were found at CT to have low-attenuation masses along lymph node chains. These masses resembled necrotic nodes. Only one patient who did not undergo laparoscopic lymph node dissection had similar findings. Fourteen patients had fluid collections within the pelvis, 13 of whom had undergone laparoscopic lymph node dissection. Other imaging findings included ectopic seeds (10 patients) and subcutaneous and intrapelvic air (11 patients). All except two patients had negative pathology reports for the removed lymph nodes.
A wide variety of imaging findings may be seen after radioactive seed implantation and laparoscopic lymph node dissection, including masses that resemble necrotic lymph nodes. Radiologists should be aware of these findings in asymptomatic patients.
本文旨在描述经会阴超声引导下放射性粒子植入联合或不联合腹腔镜淋巴结清扫术治疗前列腺癌患者的CT表现。
回顾性分析96例接受前列腺放射性粒子植入患者的骨盆CT扫描图像。CT影像结果与每位患者所接受的手术类型及腹腔镜淋巴结清扫的病理结果相关联。
在73例行腹腔镜淋巴结清扫术的患者中，CT检查发现42例患者沿淋巴结链有低密度肿块。这些肿块类似坏死淋巴结。仅1例未行腹腔镜淋巴结清扫术的患者有类似表现。14例患者盆腔内有积液，其中13例接受了腹腔镜淋巴结清扫术。其他影像学表现包括异位粒子（10例患者）及皮下和盆腔内积气（11例患者）。除2例患者外，所有切除淋巴结的病理报告均为阴性。
放射性粒子植入和腹腔镜淋巴结清扫术后可见多种影像学表现，包括类似坏死淋巴结的肿块。放射科医生应了解无症状患者的这些表现。
