Peritoneal carcinomatosis: what should be done, how, when and where?
Fiche publication
Date publication
septembre 2007
Auteurs
Lien Pubmed
Résumé
Peritoneal metastases are a common form of spread of ovarian, gastric and colorectal cancer. Tumor dissemination through the mesentery is well known with four major patterns of mesenteric tumor spread: direct spread along the mesenteric vessels and surrounding fat, extension through the mesenteric lymphatics, embolic hematogenous spread, and intraperitoneal seeding. Peritoneal implants are soft-tissue masses that appear as solitary or multiple nodules. The nodules can coalesce to form plaques that coat the viscera. Large omental plaques are called omental cakes. The implants may enhance with intravenous contrast material and may calcify. However, some implants are low in attenuation. A negative CT-scan does not exclude peritoneal carcinomatosis. With multidetector CT, thin section abdominopelvic images can be obtained to assess for subcentimeter implants and to create multiplanar images that can be used to confirm the presence of implants and to assess areas that can be difficult to evaluate on axial images such as the diaphragm, paracolic gutters, bowel, and cul-de-sac of Douglas. It is important, in a patient with a clinical background of peritoneal carcinomatosis to know which imaging technique to use, what features should be searched and where to look for them. The article presents the characteristic appearances of peritoneal carcinomatosis that can help the radiologist to improve detection of peritoneal metastases.
Référence
Feuill Rad. 2007 Sep;47(4):260-7