MRI evaluation of bulky tumor masses in the mesentery and bladder involvement in peritoneal carcinomatosis.
OBJECTIVE
Peritonectomy procedures with intraperitoneal chemohyperthermia are an effective but costly treatment for peritoneal carcinomatosis (PC). Consequently a proper selection of patients is necessary. We evaluated the benefit of MRI prior to surgery, in the detection of two of the main surgery contraindications: bulky mesenteric tumors and bladder implants.


METHODS
Three experts retrospectively reviewed abdominal and pelvic MRI from 19 cases of surgically proved PC (ovary: 7; colorectal: 7; gastric: 2; pseudomyxoma peritonei: 2; appendix: 1).


RESULTS
Mesenteric tumors were always identified as hypersignal masses on axial and coronal fat suppression gadolinium-enhanced T1 images (n=3). Three out of five bladder implants were detected. The two cases of bladder implants that were not detected on MRI were missed because the bladder was not filled. The best sequence for the detection of bladder involvement was axial T2-weighted images with bladder filling.


CONCLUSIONS
Evaluating the preoperative resectability of PC is crucial for patient management. MRI seems to reliably detect bulky mesenteric tumors and bladder implants on condition the bladder is filled and appropriate sequences are used.
Cotton
F
F
Service de Radiologie, MRI Center, Centre Hospitalier Lyon Sud, 69495 Pierre Bénite Cedex, France. francois.cotton@chu-lyon.fr
Pellet
O
O
Gilly
F-N
FN
Granier
A
A
Sournac
L
L
Glehen
O
O
D002277:Carcinoma / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery; D003287:Contrast Media; D005682:Gadolinium; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D007422:Intestines / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008536:Meglumine / Q000031:analogs & derivatives; D008643:Mesentery / Q000473:pathology*; D009942:Organometallic Compounds; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D005682:Gadolinium