摘要
目的：分析阑尾黏液性囊性病变的CT和MRI影像特征，结合其临床表现，以提高对其诊断水平。方法：搜集我院经手术及病理证实的阑尾黏液性囊性病变19例，其中单纯黏液性囊肿1例、黏液性囊腺瘤17例、黏液性囊腺癌伴腹腔假黏液瘤1例，回顾性分析其影像及临床表现。结果：临床表现：右下腹闷胀痛15例（78.9%），扪及右下腹部包块9例（47.4%），右下腹压痛6例（31.6%）。影像特征：14例阑尾腔扩张呈长管状，病变直径平均2.95 cm。13例病灶边缘光整。囊壁厚度在2 mm以下9例（47.4%），病灶内出现分隔5例（26.3%）。增强扫描囊壁无强化5例，囊壁轻度强化7例。出现钙化7例（36.8%），其中1例为黏液性囊腺癌，其余均为黏液性囊腺瘤。MRI表现为阑尾腔黏液呈典型的长T1长T2信号，信号均匀，增强扫描未见强化。结论：阑尾黏液性囊性病变的CT及MRI表现具有一定特征性，结合临床表现，可作出准确的术前诊断。
Abstract
Objective: To evaluate the CT and MR imaging findings and clinical features of appendiceal mucinous cystic lesions and to improve diagnosis capability. Methods: Nineteen cases of histologically proved appendiceal mucinous cystic lesions were retrospectively reviewed, including 1 case of simple mucinous cyst, 17 cases of mucinous cystadenoma, 1 case of mucinous cystadenocarcinoma with pseudomyxoma peritonei. The data were analyzed including imaging and clinical manifestation. Results: The clinical manifestations included nausea and right lower quadrant abdominal pain in 15 cases(78.9%), palpable mass in the right lower abdomen in 9 cases(47.4%), right lower quadrant tenderness in 6 cases(31.6%). None of these cases presented with fever. Imaging features included: tubular dilation of appendiceal lumen in 14 cases, gourd-like expansion in two cases. The average diameter of the lesions was 2.95 cm. There were 13 lesions(68.4%) with smooth margin and 3 lesions with rough edge. Nine cases(47.4%) had wall thickness of 2 mm or less. Inner separation of the lesions was seen in 5 cases(26.3%), including one case of mucinous cystadenocarcinoma. Enhanced scan revealed that the wall had no enhancement in 5 cases and slightly enhancement in 7 cases. The synchronic enhancement of the separations was showed in 3 cases. The wall of the lesions enhanced significantly in 3 cases. Calcification was seen in 7 cases(36.8%), including a mucinous cystadenocarcinoma and 6 mucinous cystadenoma. MR imaging features of the lesions were typically homogeneous hypointensity on T1-weighted and hyperoinstensity on T2-weighted imaging. One of the 2 cases showed slightly enhanced cystic wall while the other didn’t. Conclusion: The CT and MR imaging features of appendiceal mucinous cystic lesions are characteristic. Combining with the correlative clinical manifestations, we can make an accurate preoperative diagnosis.
关键词
阑尾肿瘤 /
体层摄影术 /
X线计算机 /
磁共振成像
Key words
Appendiceal neoplasms /
Tomography /
X-ray computed /
Magnetic resonance imaging
胡燕标;苏明进;肖维华;王金瑜;夏诗勇;陈富星;李 辉;彭志毅;邹 煜.
阑尾黏液性囊性病变影像与临床表现分析[J]. 中国临床医学影像杂志. 2014, 25(12): 864-869
HU Yan-biao;SU Ming-jin;XIAO Wei-hua;WANG Jin-yu;XIA Shi-yong;CHEN Fu-xing;LI Hui;PENG Zhi-yi;ZOU Yu.
Analysis of appendiceal mucinous cystic lesions with imaging and clinical manifestations[J]. Journal of China Clinic Medical Imaging. 2014, 25(12): 864-869
中图分类号：
Ｒ735.36
Ｒ814.42
Ｒ445.2
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