Analysis of appendiceal mucinous cystic lesions with imaging and clinical manifestations

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

Journal of China Clinic Medical Imaging ›› 2014, Vol. 25 ›› Issue (12) : 864-869.

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Analysis of appendiceal mucinous cystic lesions with imaging and clinical manifestations

HU Yan-biao1, SU Ming-jin1, XIAO Wei-hua1, WANG Jin-yu1, XIA Shi-yong1,
CHEN Fu-xing1, LI Hui1, PENG Zhi-yi2, ZOU Yu2

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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.

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Appendiceal neoplasms / Tomography / X-ray computed / Magnetic resonance imaging

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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