Multi-phaseenhancedCTfindingsandpathologicalbasisoflocalized malignantperitonealmesothelioma / 实用放射学杂志

ABSTRACT

Objective ToinvestigatetheenhancedCTfindingsandpathologicalfeaturesoflocalized malignantperitonealmesothelioma (LMPM)andimprovetheaccuracyofdiagnosis.Methods Theimagingandclinicaldataof5casesofLMPMconfirmedbypathology werecollected,thefeaturesofCTenhancedimagingwereanalyzedretrospectivelyandcomparedwiththepathologicalresults.Results Allofthe5caseswereisolatedsolidandcysticmasswithirregularshape,andtherangeofmaximumdiameterofthelesionbeing 8.4-13.3cm,inwhich1casewaspolycystic,andtheother4casesweresolidandcysticmass.CTvalueofthecysticpartwasabout 13.0-27.8 HU,andnoenhancementshowedoncontrast-enhancedphase.Thethicknessofcysticwallandseparationwasuneven, whiletheCTvalueofsolidpartwasabout32.6-40.8HU,andmoderateenhancementwasseeninarterialphase(△CTvaluewasabout30.9-38.4HU ),followedbyslightlyincreaseofenhancementdegreeinvenousphase,andthedecreaseofenhancementdegreeinequilibriumphase. Separationandalotofvesselshadowwereseenin3caseswhileperitonealcavity,pelviceffusionandintraperitonealimplantmetastasiswereseen in1case.Forthepathologicaltypesofpatientsinthisgroup,1casewasepithelialtype,mainlycomposedofcysticcomponent,andthe other4caseswerefibroustypeorbiphasictype,mainlycomposedofcysticandsolid,withsmallcysticdegeneration,necrosis,fibrousseptum, bloodsupplyvessels,andetc.Somelesionsinvadedthesurroundingstructure.Conclusion Thepathologicaltypesoflocalizedmalignantperitoneal mesotheliomaaremostlyfibroustypeandbiphasictypewhichCTfindingsaremostlymanifestedascysticandsolidmasses.Lobulatedand wallnodules,uneventhicknessofcysticwallandseptumcanbeseen,andthedensityofcysticpartialisrelativelyhigher.Solidpartis moderateenhancement,andinvenousphaseismoreobviouswithenhancedvascularseenintheseptum.CTenhancementcombined withclinicalmanifestationsarehelpfultomakeinsuggestivediagnosis.