CT FINDINGS OF CARCINOMATOSIS PERITONEI
Abstract
OBJECTIVE 1. To illustrate the CT findings in 15 cases of carcinomatosis peritonei
2. To determine the suggestive signs of carcinomatosis peritonei.
Abdominal CT scans in fifteen patients with proven carcinomatosis peritonei were reviewed retrospectively. CT findings were evaluated for: 1) the presence, amount and distribution of ascites; 2) the morphologic appearance of the peritoneum, omentum, mesentery and bowel 3) the presence of lymphadenopathy and hepatosplenic involvement.
The peritoneum was thickened and enhanced after intravenous contrast in all cases. Ascites was present in fourteen patients and was large in eight patients. Loculation of the fluid occurred in seven patients. In three patients, despite generalized ascites; there was a notable lack of ascitic fluid in the cul-de-sac. Mesenteric infiltration was noted in twelve cases. Omental involvement was visible as soft tissue permeation of fat, enhancing nodules and/or extrinsic omental masses in nine cases. Bowel wall thickening was present in three cases. Masses in the cul-de-sac were found in five cases and were believed to represent drop metastases. Lymphadenopathy was present in four cases, liver metastasis in five cases and splenic metastasis in three cases.
Carcinomatosis peritonei should be suspected when there is enhancing peritoneal thickening accompanied by a large amount of ascites, mesenteric infiltration or omental involvement. Although not always present, bowel wall thickening, lymphadenopathy and hepatosplenic metastases also support the diagnosis.
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Jeffrey RB. CT demonstration of peritoneal implants. AJR; 1980:135:323-6.
Jolles H, Coulan CM. CT of ascites: Differential diagnosis. AJR 1980;135:- 315-22.
Walkey MM, Friedman AC, Sohotra P, et al. CT manifestations of peritoneal carcino- matosis. AJR 1988;150:1035-41.
Demirkazik FB, Akhan O, Özmen MN, et al. US and CT findings in diagnosis of tuberculous peritonitis. Acta Radiol 1996;- 37:517-20.
Epstein BM, Mann JH. CT of abdominal tuberculosis. AJR 1982;139:861-6
Hulnick DH, Megibow AJ, Naidich DP, et al. Abdominal tuberculosis: CT evaluation. Radiology 1985;157:199-204.
Zirinsky K, Auh YH. Knee land and JR, et al. Computed tomography, sonography, and MR imaging of abdominal tuberculosis. J Comput Assist Tomogr 1985;9:961-3.
Ha HK, Jung JI, Lee MS, et al. CT differen- tiation of tuberculous peritonitis and peritoneal carcinomatosis. AJR 1996;167:- 743-8
Reginella RF, Sumkin JH, Sclerosing peritonitis associated with luteinized thecomas. AJR 1996;167:512-3.
Papadatos D, Taourel P, Bret PM. CT of Leiomyomatosis peritonealis disseminata mimicking peritoneal carcinomatosis. AJR 1996;167;475-6.
Akhan O, Kalyoncu F, Ozmen MN, et al. Peritoneal mesothelioma: Sonographic findings in nine cases. Abdom Imaging 1993;18:280.
Meyer MA. Distribution of intra-abdominal malignant seeding: Dependency on dynamics of flow of ascitic fluid. AJR 1973;119:198-206.
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