【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。更多还原

【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 5cases(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.更多还原