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MRI of the Peritoneum

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MRI of the Gastrointestinal Tract

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Key Points

The peritoneum forms an extensive network of serous membranes that line the abdominal cavity and coat the abdominal viscera. Involvement of the peritoneum by inflammatory and neoplastic diseases can be exceedingly challenging to image. The high contrast resolution of MR imaging makes it uniquely suited for depicting peritoneal disease. Abnormal peritoneal enhancement and thickening are extremely sensitive indicators of peritonitis or peritoneal tumor. Delayed gadolinium-enhanced MR images are most sensitive for depicting peritoneal inflammation and carcinomatosis owing to their slow accumulation of contrast material. Peritoneal disease also shows restricted diffusion and is displayed as areas of high signal intensity on diffusion-weighted MR imaging. Compared to helical CT and PET, MR imaging is a more sensitive test for depicting small volume peritoneal tumors and carcinomatosis.

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References

  • Akhan O, Pringo J (2002) Imaging of abdominal tuberculosis. Eur Radiol 12:312–323

    Article  PubMed  Google Scholar 

  • American Cancer Society (2008) Cancer Facts and Figures 2008. Atlanta, Ga: American Cancer Society

    Google Scholar 

  • Arai K, Makino H, Morioka T, et al. (1993) Enhancement of ascites on MRI following intravenous administration of Gd-DTPA. J Comput Assist Tomogr 17:617–622

    Article  PubMed  CAS  Google Scholar 

  • Arenas AP, Sanchez LV, Albilklos JM, et al. (1994) Direct dissemination of pathologic abdominal processes through perihepatic ligaments: identification with CT. Radiographics 14:515–528

    PubMed  CAS  Google Scholar 

  • Beets-Tan RGH, Beets GL (2004) Rectal cancer: review with rmphasis on MR imaging. Radiology 232:335–346

    Article  PubMed  Google Scholar 

  • Burghardt E, Girardi F, Lahousen M, et al (1991)Patterns of pelvic and paraaortic lymph node involvement in ovarian cancer. Gynecol Oncol 40:103–106

    Article  PubMed  CAS  Google Scholar 

  • Brown G, Richards CJ, Newcombe RG, et al. (1999) Rectal carcinoma: thin-section MR imaging for staging in 28 patients. Radiology 211:215–222

    PubMed  CAS  Google Scholar 

  • Cerame MA (1988) A 25-year review of adenocarcinoma of the appendix: a frequently perforating carcinoma. Dis Colon Rectur 31:143–150

    Google Scholar 

  • Choi JH, Kim JH, Kim JJ, et al. (2004) Large bowel obstruction caused by sclerosing peritonitis: contrast-enhanced CT findings. Br J Radiol 77:344–346

    Article  PubMed  CAS  Google Scholar 

  • Coakley F V, Hricak H (1999) Imaging of peritoneal and mes-enteric disease: key concepts for the clinical radiologist. Clin Radiol 54:563–574

    Article  PubMed  CAS  Google Scholar 

  • Coakley F V, Choi, PH, Gougoutas CA, et al.(2002) Peritoneal metastases: detection with spiral CT in patients with ovarian cancer. Radiology 223:495–499

    Article  PubMed  Google Scholar 

  • Cunha P, Luz Z, Seves I, et al. (2002) [Malignant peritoneal mesothelioma — diagnostic and therapeutic difficulties]. Acta Med Port 15:383–386

    PubMed  CAS  Google Scholar 

  • Elsayes KM, Staveteig PT, Narra VR, et al. (2006) MRI of the peritoneum: spectrum of abnormalities. AJR Am J Roentgenol 186:1368–1379

    Article  PubMed  Google Scholar 

  • Eltabbakh GH, Piver MS (1998) Extraovarian primary peritoneal carcinoma. Oncology 12:813–819

    PubMed  CAS  Google Scholar 

  • Emory TS, Monihan JM, Carr NJ, et al. (1997) Sclerosing mes-enteritis, mesenteric panniculitis and mesenteric lip-odystrophy: a single entity? Am J Surg Pathol 21:392–398

    Article  PubMed  CAS  Google Scholar 

  • Fuji S, Matsusue E, Kanasaki Y, et al. (2008) Detection of peritoneal dissemination in gynecological malignancy: evaluation by diffusion-weighted MR imaging. Eur Radiol 18:18–23

    Article  Google Scholar 

  • Fujiyoshi F, Ichinari N, Kajiya Y, et al. (1997) Retractile mesen-teritis: small-bowel radiography, CT, and MR imaging. AJR Am J Roentgenol 169:791–793

    Article  PubMed  CAS  Google Scholar 

  • Glehen O, Kwiatkowski F, Sugargaker PH, et al. (2004) Cytoreductive surgery combined with perioperative intrap-eritoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a Multi-Institutional Study. J Clin Oncol 22:3284–3292

    Article  PubMed  CAS  Google Scholar 

  • Ha HK, Jung JI, Lee MS, et al. (1996) CT differentiation of tuberculous peritonitis and peritoneal carcinomatosis. AJR Am J Roentgenol 167:743–748

    Article  PubMed  CAS  Google Scholar 

  • Hamrick-Turner JE, Chiechi M V, Abbitt PL, et al. (1992) Neoplastic and inflammatory processes of the peritoneum, omentum, and mesentery: diagnosis with CT. Radiographics 12:1051–1068

    PubMed  CAS  Google Scholar 

  • Hossein J, Bindelzun RE, Olcott EW, et al. (1997) Still the great mimicker: abdominal tuberculosis. AJR Am J Roentgenol 168:1455–1460

    Article  Google Scholar 

  • Hüser N, Stangl M, Lutz J, et al. (2006) Sclerosing encapsulating peritonitis: MRI diagnosis. Eur Radiol 16:238–239

    Article  PubMed  Google Scholar 

  • Ichikawa T, Erturk SM, Motosugi U, et al. (2006) High-B-value diffusion weighted MRI in colorectal cancer. AJR Am J Roentgenol 187:181–184

    Article  PubMed  Google Scholar 

  • Ichikawa T, Haradome HH, Hachiya J, et al. (1999) Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen: preliminary clinical experience in 61 patients. Abdom Imag 24:456–461

    Article  CAS  Google Scholar 

  • Kanematsu M, Hoshi H, Murakami T, et al. (1997) Spontaneous bacterial peritonitis in cirrhosis: enhancement of ascites on delayed MR imaging. Radiat Med 15:185–187

    PubMed  CAS  Google Scholar 

  • Kim SY, Kim MJ, Chung JJ, et al. (2000) Abdominal tuberculous lymphadenopathy: MR imaging findings. Abdom Imaging 25:627–632

    Article  PubMed  CAS  Google Scholar 

  • Kobayashi S, Takeda K, Tanaka N, Hirano T, Nakagawa T, Matsukmoto K (1993) Mesenteric panniculitis: MR find-ings. J Comput Assist Tomogr 17:500–502

    Article  PubMed  CAS  Google Scholar 

  • Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635

    Article  PubMed  Google Scholar 

  • Kronthal AJ, Kang YS, Fishman EK, et al. (1991) MR imaging in sclerosing mesenteritis. AJR Am J Roentgenol 156:517–519

    Article  PubMed  CAS  Google Scholar 

  • Leder RA, Low VHS (1995) Tuberculosis of the abdomen. Radiol Clin North Am 33:691–705

    PubMed  CAS  Google Scholar 

  • Low RN (2001) Gadolinium-enhanced MR imaging of liver capsule and peritoneum. Magn Reson Imaging Clin N Am 9:803–819

    PubMed  CAS  Google Scholar 

  • Low RN (2007) MR imaging of the peritoneal spread of malignancy. Abdom Imaging 32:267–283

    Article  PubMed  Google Scholar 

  • Low RN, Gurney J (2007) Diffusion-weighted MRI (DWI) in the oncology patient: value of breath hold DWI compared to unenhanced and gadolinium-enhanced MRI. J Magn Reson Imaging 25:848–858

    Article  PubMed  Google Scholar 

  • Low RN, Sigeti JS (1994) MR imaging of peritoneal disease: comparison of contrast-enhanced fast multiplanar spoiled gradient-recalled and spin-echo imaging. AJR Am J Roentgenol. 163:1131–1140

    Article  PubMed  CAS  Google Scholar 

  • Low RN, Barone RM, Gurney JM, et al. (2008) Mucinous appen-diceal neoplasms: preoperative mr staging and classification compared with surgical and histopathologic findings. AJR Am J Roentgenol 190:656–665

    Article  PubMed  Google Scholar 

  • Low RN, Barone RM, Lacey C, et al. (1997) Peritoneal tumor: MR imaging with dilute oral barium and intravenous gadolinium-containing contrast agents compared with unen-hanced MR imaging and CT. Radiology 204:513–520

    PubMed  CAS  Google Scholar 

  • Low RN, Barone R, Sebrechts C, et al. (2009) Diffusion weighted MR imaging of peritoneal tumor: comparison with conventional MR imaging, and surgical and histopathologic findings. Am J Roentgenol AJR 193:461– 470

    Article  Google Scholar 

  • Low RN, Carter WD, Saleh F, et al. (1995) Ovarian cancer: comparison of findings with perfluorocarbon-enhanced MR imaging, In-111-CYT-103 Immunoscintigraphy, and CT. Radiology 195:391–400

    PubMed  CAS  Google Scholar 

  • Low RN, Duggan B, Barone RM, et al. (2005) Treated ovarian cancer: MR imaging, laparotomy reassessment, and serum CA-125 values compared with clinical outcome at 1 year. Radiology 235:918–926

    Article  PubMed  Google Scholar 

  • Low RN, Saleh F, Song SY, et al. (1999) Treated ovarian cancer: comparison of MR imaging with serum CA-125 level and physical examination–a longitudinal study. Radiology 211:519–528

    PubMed  CAS  Google Scholar 

  • Manohar A, Simjee AE, Haffejee AA, et al. (1990) Symptoms and investigative findings in 145 patients with tuberculous peritonitis diagnosed by peritoneoscopy and biopsy over a five year period. Gut 31:1130–1132

    Article  PubMed  CAS  Google Scholar 

  • Menassa-Moussa L, Bleibel L, Sader-Ghorra C, et al. (2006) MRI find-ings in intestinal cocoon. AJR Am J Roentgenol 186:905–906

    Article  PubMed  Google Scholar 

  • Meyers MA (2000) Dynamic radiology of the abdomen. normal and pathologic anatomy, 5th edn. Springer, New York

    Google Scholar 

  • Meyers MA et al. (1987) The peritoneal ligaments and mesenteries: pathways of intra abdominal spread of disease. Radiology 163:593–604

    PubMed  CAS  Google Scholar 

  • Mohamed F, Sugarbaker PH (2002) Peritoneal mesothelioma. Curr Treat Options Oncol 3:375–386

    Article  PubMed  Google Scholar 

  • Nakajima T, Harashima S, Hirata M, et al. (1978) Prognostic and therapeutic values of peritoneal cytology in gastric cancer. Acta Cytol 22:225–229

    PubMed  CAS  Google Scholar 

  • NIH consensus conference (1995) Ovarian cancer. Screening, treatment, and follow-up. NIH Consensus Development Panel on Ovarian Cancer. JAMA 273:491–497

    Article  Google Scholar 

  • Pereira J, Madureira A, Vieira A, et al. (2005) Abdominal tuberculosis: imaging features. Eur J Radiol 55:173–180

    Article  PubMed  Google Scholar 

  • Piver MS, Jishi MF, Tsukada Y, et al. (1993) Primary peritoneal carcinoma after prophylactic oophorectomy in women with a family history of ovarian cancer. A report of the gilda radner familial ovarian cancer registry. Cancer Cytopathol Cancer 71:2751–2755

    Article  CAS  Google Scholar 

  • Puvaneswary M, Chen S, Proietto T (2002) Peritoneal meso-thelioma: CT and MRI findings. Australas Radiol 46:91–96

    Article  PubMed  CAS  Google Scholar 

  • Qayyum A, Coakley F V, Westphalen AC, et al. (2005) Role of CT and MR imaging in predicting optimal cytoreduction of newly diagnosed primary epithelial ovarian cancer. Gynecologic Oncol 96:301–306

    Article  Google Scholar 

  • Raptopoulos V (1985) Peritoneal mesothelioma. Crit Rev Diagn Imaging 24:293–328

    PubMed  CAS  Google Scholar 

  • Ricke J, Sehouli J, Hach C, et al. (2003) Prospective evaluation of contrast-enhanced MRI in the depiction of peritoneal spread in primary or recurrent ovarian cancer. Eur Radiol 13:943–949

    Article  PubMed  Google Scholar 

  • Rigby R, Hawley C (1998) Sclerosing peritonitis: the experience in Australia. Nephrol Dial Transplant 13:154–159

    Article  PubMed  CAS  Google Scholar 

  • Ronnett RM, Zahn CM, Kurman RJ, et al. (1995) Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis: a clinicopathologic analysis of 109 cases with emphasis on distinguishg features, site of origin, prognosis, and relationship to “Psedumyxoma Peritonei.” Am J Surg Pathol 19:1390–1408

    Article  PubMed  CAS  Google Scholar 

  • Slim R, Tohme C, Yaghi C, et al. (2005) Sclerosing encapsulating peritonitis: a diagnostic dilemma. J Am Coll Surg 200:974–975

    Article  PubMed  Google Scholar 

  • Sugarbaker PH, Welch LS, Mohamed F, et al. (2003) review of peritoneal mesothelioma at the Washington Cancer Institute. Surg Oncol Clin N Am 12:605–621

    Article  PubMed  Google Scholar 

  • Tarzi RM, Lim A, Moser S, et al. (2008) Assessing the validity of an abdominal CT scoring system in the diagnosis of encapsulating peritoneal sclerosis. Clin J Am Soc Nephrol 3:1702–1710

    Article  PubMed  Google Scholar 

  • Vikram R, Balachandranm A, Bhosale PR, et al. (2009) Pancreas: peritoneal reflections, ligamentous connections, and pathways of disease spread. RadioGraphics (Published Online Only). http://radiographics.rsnajnls.org/cgi/con-tent/abstract/e34v1

    Google Scholar 

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Authors and Affiliations

  1. Sharp and Children's MRI Center, 7901 Frost Street, San Diego, CA, 92123, USA

    Russell N. Low

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  1. Russell N. Low
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Editors and Affiliations

  1. Department of Radiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, AZ, 1105, The Netherlands

    J. Stoker (Professor of Radiology) (Professor of Radiology)

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© 2010 Springer-Verlag Berlin Heidelberg

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Low, R.N. (2010). MRI of the Peritoneum. In: Stoker, J. (eds) MRI of the Gastrointestinal Tract. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85532-3_15

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  • DOI: https://doi.org/10.1007/978-3-540-85532-3_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-85531-6

  • Online ISBN: 978-3-540-85532-3

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