Detection of peritoneal metastases

Direct spread along peritoneal ligaments, mesenteries and omenta to non-contiguous organs. Intraperitoneal seeding via ascitic fluid. Lymphatic extension. Embolic haematogenous spread. Before the introduction of cross-sectional imaging, the peritoneum and its reflections could only be imaged with difficulty, often requiring invasive techniques. Computed tomography and to a lesser extent sonography and MR imaging allow us to examine the complex anatomy of the peritoneal cavity accurately, which is the key to understanding the spread of peritoneal metastases. This article reviews the detection of peritoneal metastases.