阑尾黏液性囊性病变影像与临床表现分析
Analysis of appendiceal mucinous cystic lesions with imaging and clinical manifestations
胡燕标 1苏明进 1肖维华 1王金瑜 1夏诗勇 1陈富星 1李辉 1彭志毅 2邹煜2
作者信息
- 1. 宁波市北仑区人民医院,浙江宁波315807
- 2. 浙江大学医学院附属第一医院放射科,浙江杭州 310003
- 折叠
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引用本文复制引用
基金项目
浙江省教育厅基金资助项目(Y201225858)
出版年
2014
国家科技期刊平台
NSTL
维普
万方数据