腹膜转移瘤的T诊断及鉴别-2.ppt

4、腹膜结核 出现肠系膜大结节 可见侧腹壁均匀增厚及强化（平滑均匀） 脾肿大，脾脏钙化灶 回盲部肠壁受累 后腹膜及胰腺周围的淋巴结肿大，低密度中心及环形强化 Figure 16. Peritoneal tuberculosis in a 45-year old Senegalese male. A and B. Presence of left iliac and splenic hilar lymphadenopathies with necrotic centre (black arrow heads). C and D. Enhancement and regular thickening of the parietal peritoneum, iliac fossae, and pelvis (white arrow heads) with free ascites (asterisk). E. Invasion of the greater omentum (black arrow) and lymph nodes of the mesenteric root. 5、脾种植 常有外伤脾脏破裂，脾切除史，无临床症状 脾脏碎片种植于腹膜腔，皮下，纵隔、胸膜腔（膈破裂） 平扫等密度，增强强化方式同脾脏，无腹水 Figure 17. Incidental sonographic discovery of soft-tissue lesions that are splenosis implants in a 45-year old female with a history of splenectomy following a road accident. A. Note the history of splenectomy (asterisk). Presence of peritoneal tissue lesions (black arrow heads) in the splenectomy site (C) and in the right peri-renal space (B). An enhancement study (white arrow heads) found isodensity to the hepatic parenchyma before administration of intravenous contrast material(D), then a non-homogeneous appearance in the arterial phase(E), becoming homogeneous in the venous phase(F). 6、弥漫性腹膜平滑肌瘤病 罕见良性病变，腹膜肌瘤结节（病理似子宫平滑肌瘤） 多见于黑人，育龄期妇女，与雌孕激素避孕药摄入有关 主要累及盆腹膜及大网膜，子宫，卵巢，脏层腹膜 延迟强化，无淋巴结肿大及胃壁增厚，无腹水及肝转移灶 Figure 18. A 45-year old female was investigated for a feeling of pressure in the pelvis leading to the incidental discovery of diffuse peritoneal leiomyomatosis(DPL) confirmed histologically by diagnostic peritoneoscopy. A and C. Large pelvic soft-tissue mass displacing the adjacent organs, enhancing progressively and non-homogeneously in the venous phase (black arrow heads). B and D. It becomes homogeneous and enhances more markedly in the delayed phase at 5 min(white arrow heads). 壁腹膜呈宽带状、条状、结节状、片絮状或粟粒状强化 胃周韧带增厚或呈条片状强化 肠系膜、大网膜呈结节状、饼状、污垢状、囊状影且不均匀强化，或呈条状、粟粒状强化 肠壁增厚或呈结节状强化，肠腔固定，可见肠道内造影剂充盈跳跃征 膀胱壁增厚或呈结节状强化；子宫边缘毛糙；双侧附件肿物呈不均匀强化 小结 * * （二）系膜 由于壁、脏腹膜相互延续移行，形成了将器官系连固定于腹、盆壁的双层腹膜结构称为系膜，其内含有出入该器官的血管、神经及淋巴管和