卵巢腫瘤的腹膜轉移在電腦斷層影像之表徵

回溯性評估原發性卵巢腫瘤在腹膜轉移之電腦斷層影像，我們選取成大醫院自1988年6月至1991年7月共30位，同時接受電腦斷層檢查並經外科病理證實之病患，做一系列的分析。 30例病患中，18例經病理證實具癌性腹膜轉移，電腦斷層影像偵測出其中之14例。陽性預估率為87.5%(14/16)，陰性預估率為71%(10/14)，準確度為80%(24/30)。分析癌性腹膜轉移病灶之表現以網膜糕塊狀，不規則腫塊，與結節狀佔多數；轉移位置以大網膜與傍結腸溝居多。在真陽性病例中，所有轉移病灶均大於5mm；4例偽陰性檢出之病例，其中有3例之病灶都小於5mm。在12例具有腹水之病患中，高達11例為陽性檢出。所有30例病患中，具肝臟轉移者佔5例。我們的結論是：以電腦斷層攝影偵測卵巢腫瘤之腹膜轉移，其取決因素主要在於病灶之大小與轉移之部位。若一卵巢腫瘤病患具有腹水，更應強烈懷疑有癌性腹膜轉移之現象發生。

關鍵字

卵巢腫瘤；腹膜腫瘤；腹部電腦斷層攝影

並列摘要

The CT features of 30 patients with proven ovarian tumors, collected from June 1988 to July 1991 in the NCKUH, were assessed retrospectively to evaluate the risk of metastatic peritoneal implants. CT demonstrated peritoneal tumor implants in 14 out of 18 patients. The positive predictive value was 87.5% (14/16), and the negative predictive value was 71% (10/14). The overall accuracy in assessment of peritoneal implants by CT was 80% in our study. Omental cake, irregular mass and nodular seedings were the most common patterns of the peritoneal implants. The greater omentum and paracolic gutters were the most commonly involved areas. In the true positive group, all the tumor seedings were larger than 5mm in size. Three out of four patients with false negative findings had the size of tumoral seeding smaller than 5mm. Among 12 patients with ascites, 11 were proven to have tumoral seedings. Five of 30 patients had liver metastasis. We conclude that the usefulness of CT in detection of tumoral implants depends on the size, location and presence of ascites.

並列關鍵字

Ovary, neoplasm ； peritoneum, neoplasm ； abdomen, CT

國際替代計量

卵巢腫瘤的腹膜轉移在電腦斷層影像之表徵

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