摘要目的 探讨增强MRI及PET/CT对腹膜假性黏液瘤(PMP)的诊断价值及良恶性鉴别的灵敏度及特异度.方法 回顾性分析2011年1月至2016年6月解放军沈阳军区总医院收治的疑似诊断为PMP的46例患者的临床资料.所有患者术前均行增强MRI及PET/CT检查,以术后病理或临床综合评价诊断为标准,比较两种检查方法在PMP诊断及良恶性鉴别中的价值.结果 46例患者中确诊为PMP者34例,非PMP者12例.增强MRI及PET/CT检查对PMP诊断的灵敏度分别为72.0%、93.7%,两者差异有统计学意义(P<0.05).在腹腔淋巴结转移判断方面,增强MRI和PET/CT的灵敏度分别为40.9%、85.6%,两者差异有统计学意义(P<0.001);在肝、脾转移判断方面,增强MRI和PET/CT的灵敏度分别为50.2%、78.9%,两者差异无统计学意义(P=0.68);在腹水良恶性判断方面,PET/CT具有较高的灵敏度,两者差异有统计学意义(P<0.05).结论 PET/CT对PMP诊断有较高的灵敏度,优于增强MRI,且PET/CT有助于发现淋巴结、肝、脾转移情况,并可通过对腹水18 F-FDG摄取的多少,间接判断PMP的良恶性,利于指导临床病理分型,为早期确立准确的治疗方案提供参考依据.

abstractsObjective To investigate enhanced MRI and PET/CT value in the diagnosis pseud-omyxoma peritonei( PMP) and distinguishing benign and malignant. Methods A retrospective study was performed on 46 PMP patients who were admitted from January 2011 to June 2016. All the patients received preoperative enhanced MRI scans and PET/CT. The diagnosis of postoperative pathological or clinical com-prehensive evaluation was standard. To compare the value of the two methods in the diagnosis of PMP′s be-nign or malignant. Results Among 46 patients, 34 cases were diagnosed with PMP and 12 cases were non PMP. The sensitivity of enhanced MRI and PET/CT examination for PMP diagnosis were 72. 0% and 93. 7%, respectively(P<0. 05). The sensitivity of enhanced MRI and PET/CT examination in diagnosis of abdominal lymph node metastasis were 40. 9% and 85. 6%, respectively(P<0. 001);the sensitivity of en-hanced MRI and PET/CT examination in the judgment of liver and spleen metastasis were 50. 2% and 78. 9%, respectively, with no statistical significance ( P =0. 68 );the sensitivity of enhanced MRI and PET/CT examination in diagnosis of benign or malignant ascites, PET/CT had a higher sensitivity and bet-ter than enhanced MRI(P<0. 05). Conclusion PET/CT in the diagnosis of PMP has a higher sensitivity than enhanced MRI, and PET/CT could help to find lymph nodes, liver and spleen metastasis, through 18 F-FDG uptake in ascites, indirectly diagnosis of PMP′s benign or malignant, guide the clinical pathologi-cal type and provide early accurate treatment plan.