Learning objectives
To understand the anatomy of the peritoneal cavity and the circulation dynamic of its fluid.
To recognize the main CT aspects of carcinomatosis and how to differentiate them form carcinomatosis like lesions.
To apprehend the correlation between the primary tumour localisation and the spread pattern of carcinomatosis.
Background
Peritoneal carcinomatosis is by definition the dissemination of primary tumours to the peritoneal surface.
It is always synonym with an overall advanced tumoral stage and bad prognosis,
if not palliative treatment when it occurs at certain anatomic structures.
Findings and procedure details
Introduction
The peritoneum is a serous membrane of mesothelial cells that lines the largest cavity of the human body (approximately 2m 2).
It covers entirely or partially the different organs of the abdomen and pelvis.
Through its folding,
it forms 11 major ligaments,
mesenteries and omentum,
which not only divide this cavity into interconnecting compartments but also fixate and support the different organs.
It maintains the homeostasis of the peritoneal fluid through its compartmentalization and its cellular biosynthetic properties that enable it of particulates and...
Conclusion
Carcinomatosis remains a challenging radiological diagnosis with serious impact on the patient treatment and quality of life.
A radiologist with a thorough understanding of the spread patterns of carcinomatosis through the different peritoneal compartments and a clear anatomical map of its most likely localizations is capable of elaborating an early more accurate diagnosis of carcinomatosis.
A systematized staging radiology report based on PCI assessment approach along with improved MDCT techniques can further improve accuracy of reporting.
References
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Diop AD,
et al.
CT imaging of peritoneal carcinomatosis and its mimics.
Diagnostic and Interventional Imaging (2014).
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Meyers MA.
Distribution of intra-abdominal malignant seeding: dependency
on dynamics of flow of ascitic fluid.
Am Roentgenol Radium Ther Nucl Med
1973; 119:198-206.
3.
Krishnamurthy S, Balasubramaniam R.
Role of Imaging in Peritoneal Surface Malignancies.
Indian Journal of Surgical Oncology [08 Jun 2016,
7(4):441-452].
4.
Chirag M.
Patel,
Anju Sahdev and Rodney H.
Reznek.
CT,
MRI and PET imaging in peritoneal malignancy.
Cancer Imaging.
2011; 11(1):...