Pseudomyxoma peritonei (PMP) may be difficult to distirnguish from ascites on imaging studies. Certain features can help to distinguish adenomucinosis from carcinomatosis.
Features of PMP vs ascites:
(1) subtle difference in fluid density (which occur when the fluid is more viscous)
(2) scalloping of liver or other viscera
Mucinous fluid may be:
(1) hyperdense on CT
(2) hyperintense on T1-weighted MRI images
(3) hypointense on T2-weighted MRI images
(4) complex echogenicity or hypoechoic with fine internal echoes on ultrasound
Features of peritoneal mucinous carcinomatosis (PMCA):