ABSTRACT
The purpose of this study was to investigate the correlation between multi-detector row CT (MDCT) features, pathological findings and the anatomic basis of extra-organic primary tumors in pelvis so as to improve the document diagnosis of these entities. We retrospectively analyzed the MDCT manifestations of 20 cases with surgically and/or pathologically evidenced diagnoses of extra-organic primary tumors in pelvis. The results showed that, in 14 cases, the tumors were located in the pelvis, and 6 of them involved both pelvis and hypogastric zone. There were 8 tumors located in the peritoneal cavity of the pelvis, and 3 of them also involved the extraperitoneal space of the pelvis. In the peritoneal cavity, 2 tumors of male patients were located in the rectovesical pouch while 3 tumors of female patients were located in the rectouterine pouch. The majority of entities in these 2 pouches were germ cell tumors (3/5 cases, 60.0%). In the extraperitoneal space, 5 of 12 tumors were located in the pararectal space and 5 of them were located in the retrorectal space. The majority entities of these 10 cases were germ cell tumors (7/10 cases, 70.0%). Lymphoma mainly involved paravesical and pararectal space in disorder. Calcification occurred in 6 cases, including 4 cases of teratoma, 1 case of neurilemmoma, and 1 case of malignant teratoma. The fatty element occurred in 7 masses, including 4 cases of teratoma, 1 case of malignant teratoma, 1 case of mixed germ cell tumor, and 1 case of liposarcoma. MDCT with multi-planar reconstruction (MPR) could more clearly reveal the anatomic location of the extra-organic primary tumor in pelvis, could unveil the tumor's relationship with its surrounding organs, and could help to differentiate benign tumors from malignant tumors.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Imaging, Three-Dimensional , Pelvic Neoplasms , Diagnostic Imaging , Pathology , Retrospective Studies , Teratoma , Diagnostic Imaging , Pathology , Tomography, Spiral ComputedABSTRACT
Objective To study the CT features of peritoneal Metastasis in post-operative patients of ovarian carcinomas.Methods CT appearance of peritoneal metastasis of ovarian carcinomas proved by surgery and pathology in 33 post-operative patients were reviewed.The CT features of the foci were recorded and analyzed,especially on the location,quantity,density and size.Results In the peritoneal cavity,186 implant foci and 10 recurrent foci were found.metastasis often occurred in the right upper abdomen,especially the right subphrenic spaces.The most frequent locations were the right suprahepatic and subhepatic spaces,the small bowel mesentery,the gastrocolic ligament and the omentum.The density of the foci was most of solid.The size was ranged from 0.5~13 cm.Conclusion Peritoneal metastasis is the most frequent route of metastases for ovarian carcinomas.It is frequently found in upper abdomen,especially in the subphrenic spaces.Localized ascites in the peritoneal cavity is another important sign suggesting peritoneal implants.CT scan from the diaphragm to the pelvic floor will be helpful to diagnose peritoneal implants in cases of post-operative ovarian carcinomas.
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Objective To investigate the MR imaging (MRI) appearances of postoperative residual liver after hepatic resection for hepatocellular carcinoma (HCC) and the MRI features of tumor recurrences.Methods Twenty patients with previous surgical resection of HCC underwent MR examination of upper abdomen for routine follow-up study or due to clinical suspicion of tumor recurrence. MRI protocol included T1W axial unenhanced images and Gadolinium-enhanced sequences, Gadolinium-enhanced VIBE sequence, unenhanced T2W axial images and coronal TrueFisp sequence.Results Thirteen patients showed normal edge of surgical resection, while 6 patients demonstrated MR signs of incision edge recurrence of HCC and 1 patient was suspicious of tumor recurrence at the incision edge. Among the 20 patients, 12 had MRI features of tumor recurrence of the residual liver, including invasion of left, right and common hepatic ducts 3 cases. Three patients had metastatic lymphadenopathy in portal hepatis, portacaval space and retroperitoneal space. Two patients showed extensive tumor implantation of peritoneum and mesentery. Conclusion MRI is effective in differentiating normal surgical incision edge of residual liver from tumor recurrence. It is also very useful for the early detection of intra-hepatic and extra-hepatic tumor lesions.
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Objective To investigate the CT presenting rate and features of gastric bare area (GBA, including the area posterior to GBA and the adipose tissue in the gastrophrenic ligament) without pathologic changes.Methods Thirty cases with superior peritoneal ascites, but without pathological involvement of GBA were included into the study to show the normal condition of GBA, including the presenting rate and CT features. We selected some cases with GBA invasion by inflammation or neoplasm to observe their CT features. Results All cases with superior peritoneal ascites showed the GBA against the contrast of ascites with the presenting rate of 100%. The GBA appeared at the level of gastric esophageal conjunction and completely disappeared at the level of hepato duodenal ligament and Winslow’s foramen. The maximum scope of GBA presented at the level of the sagital part of the left portal vein with mean right to left distance of (4.39? 0.08 )cm (3.8～5.7 cm) (distance between the left and right layer of the gastrophrenic ligament). In acute pancreatitis, the width of GBA increased, in which local hypo density area could be seen. In gastric leiomyosarcoma invading GBA, the mass could not separate from the crus of the diaphragm. In lymphoma and metastasis invading GBA, the thickness of GBA increased and the density was heterogeneous, in which lymph nodes presenting as small nodes or fused mass. Conclusion The results of this study show that it is helpful to use contrast enhanced spiral CT scanning to observe the change of GBA and to diagnose retroperitoneal abnormalities that involving GBA comprehensively and accurately.
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Objective To study the correlation between the manifestations of the left subphrenic fat infiltration (LSFI) and the severity of acute pancreatitis (AP) Methods One hundred and forty four cases and 188 cases of AP scored by Ranson′s scoring system and graded by Balthazar′s staging system were retrospectively studied respectively The thickness of the LSFI in each case was respectively and individually observed and measured, and the thickness under 3 mm was graded as 0 of which the sign of LSFI was considered as negative Rank correlation analysis of the thickness of LSFI with Ranson′s scoring and Balthazar′s staging was used respectively Results The incidence of LSFI in Ranson′s rank 1-3 was 30 86%, 54 90%, and 75 00%, respectively, and rank correlation coefficient of LSFI and Ranson′s score was 0 417 9( P
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Objective To analyze the CT contrast enhanced features of the extra-organic primary tumors in pelvis and to evaluate anatomic bases of these imaging characteristics.Methods CT findings in 14 patients with pathologically proved extra-organic primary tumors in pelvis were reviewed retrospectively for tumor size,density,margins,contrast enhanced characteristics,location and relationship of the lesions with surrounding organs and tissues.Results There were benign tumors (n=3) and malignant tumors(n=11) in this study.There were 6 lesions in peritoneal cavity and 6 in retroperitoneal space of pelvis respectively,and two other masses were in both peritoneal cavity and retroperitoneal space of pelvis.CT scan revealed that there were 6 solid masses and 8 cystic-solid masses.The enhanced characteristics of lesions were homogeneous and heterogeneous in 3 and 11 patients respectively.The fatty space surrounding the lesion was invasive in 7 cases and all of them were malignant tumor.The fatty space surrounding lesion was clear in other 7 cases including 3 benign tumors and 4 malignant tumors.CT revealed calcification in 4 lesions including benign teratoma (n=2) , malignant teratoma (n=1), and carcinoid (n=1).Conclusion In the diagnosis of extra-organic primary tumors in pelvis,CT enhancement scan can reveal the anatomic location and relationships of the lesions with surrounding organs and tissues and can differentiate benign and malignant tumor to some degree.