Diagnostic Ultrasound - Abdomen and Pelvis

09.07.2019 Views

Peritoneal Carcinomatosis (Left) Longitudinal panoramic ultrasound of the right abdominal abdominal wall in a patient with metastatic squamous cervical carcinoma. There is a peritoneal metastasis ſt invading the abdominal wall fascia . (Right) CECT of the same patient shows multiple peritoneal metastases ſt and small bowel obstruction . The metastasis causing the obstruction is not shown. Diagnoses: Abdominal Wall/Peritoneal Cavity (Left) Longitudinal ultrasound of the pelvis in a patient with recurrent endometrial carcinoma in the peritoneal cavity shows a septated cystic peritoneal mass ſt and ascites st. A more solid mass is deeper. (Right) Axial CECT of the same patient shows ascites st and multiple peritoneal masses ſt with central cystic change. There is minimal adenopathy . (Left) Transverse color Doppler ultrasound of a peritoneal metastasis invading the abdominal wall ſt in a patient with pancreatic neuroendocrine carcinoma shows the mass is well perfused. The presence of ascites st improves detection of peritoneal masses. (Right) Axial CECT of the same patient shows the superficial metastasis extending through the umbilicus ſt, but also multiple other intraperitoneal metastases st, one of which is calcified. 631

Peritoneal Carcinomatosis Diagnoses: Abdominal Wall/Peritoneal Cavity (Left) Transverse ultrasound of the upper abdomen shows a thickened heterogeneous omentum ſt with underlying bowel st. Core biopsies showed mucinous adenocarcinoma. (Right) Axial CECT of the same patient shows the extent of the omental cake ſt. The omentum contains soft tissue and fat densities. A large amount of ascites st is present. (Left) Panoramic transverse ultrasound (same patient) of the upper abdomen shows the extent of the hypoechoic omental cake ſt displacing bowel posteriorly. (Right) Axial NECT of a patient with a renal transplant and abdominal distension ſt shows an extensive omental cake displacing bowel . Ascites st is mild. Omental biopsy confirmed ovarian carcinoma. (Left) Axial NECT of the same patient confirms thickening of the peritoneum ſt and a large pelvic mass st. The lower pole of a renal transplant is noted. (Right) Transvaginal ultrasound of a patient with ovarian carcinomatosis shows that in the left adnexa there is a soft tissue plaque ſt along the peritoneum as well as a solid mass st. Surrounding ascites contains low-level echoes . 632

Peritoneal Carcinomatosis<br />

(Left) Longitudinal panoramic<br />

ultrasound of the right<br />

abdominal abdominal wall in a<br />

patient with metastatic<br />

squamous cervical carcinoma.<br />

There is a peritoneal<br />

metastasis ſt invading the<br />

abdominal wall fascia .<br />

(Right) CECT of the same<br />

patient shows multiple<br />

peritoneal metastases ſt <strong>and</strong><br />

small bowel obstruction .<br />

The metastasis causing the<br />

obstruction is not shown.<br />

Diagnoses: Abdominal Wall/Peritoneal Cavity<br />

(Left) Longitudinal ultrasound<br />

of the pelvis in a patient with<br />

recurrent endometrial<br />

carcinoma in the peritoneal<br />

cavity shows a septated cystic<br />

peritoneal mass ſt <strong>and</strong> ascites<br />

st. A more solid mass is<br />

deeper. (Right) Axial CECT of<br />

the same patient shows<br />

ascites st <strong>and</strong> multiple<br />

peritoneal masses ſt with<br />

central cystic change. There is<br />

minimal adenopathy .<br />

(Left) Transverse color<br />

Doppler ultrasound of a<br />

peritoneal metastasis invading<br />

the abdominal wall ſt in a<br />

patient with pancreatic<br />

neuroendocrine carcinoma<br />

shows the mass is well<br />

perfused. The presence of<br />

ascites st improves detection<br />

of peritoneal masses. (Right)<br />

Axial CECT of the same<br />

patient shows the superficial<br />

metastasis extending through<br />

the umbilicus ſt, but also<br />

multiple other intraperitoneal<br />

metastases st, one of which is<br />

calcified.<br />

631

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