64层螺旋CT对回盲部恶性肿瘤的诊断价值

The diagnostic value of 64-slice spiral CT in malignant tumors arising in the ileocecal area

目的:探讨回盲部恶性肿瘤的临床病理特点及64层螺旋CT的诊断价值。方法:回顾性分析48例回盲部恶性肿瘤的病理特点及64层螺旋CT表现。结果:腺癌36例,其中以盲肠腺癌为主者28例,阑尾腺癌为主5例,多数病例CT表现为较大的肿块,密度不均、中等强化,浆膜面有浸润;淋巴瘤7例,CT表现为环状或对称性肠壁增厚,密度较均匀,呈轻度强化;恶性胃肠间质瘤2例,CT表现为圆形或类圆形肿块,边界相对较清,周边部分明显强化;转移瘤2例,CT表现为软组织肿块,无特异性。结论:回盲部常见的几种类型恶性肿瘤,采用64层螺旋CT快速增强薄层扫描,利用多平面重建及最大密度投影重建可以充分显示病变的组织学特征,有助于定性诊断。

Objective：To evaluate the diagnostic value of a 64-slice spiral CT in common malignant tumor arising in the ileocecal area.Methods：CT findings of using a 64-slice Spiral CT on 48 patients with pathologically and surgically proven malignant tumors arising in the ileocecal area were retrospectively analyzed.Results：There were 36 cases of adenocarcinoma,including cecal adenocarcinomas（28 cases）,adenocarcinomas of the appendix（five cases）,adenocarcinomas of the ileocecal valve（three cases）,CT features such as a large mass with heterogeneous attenuation or marked asymmetric colic wall thickening,short segment involvement,demonstrated mild local infiltration,with moderate enhancement;seven cases of lymphoma,most commonly manifests as single or multiple segmental areas of circumferential thickening with homogeneous attenuation and poor enhancement;two cases of malignant gastrointestinal stromal tumors,which the CT featured as sharply marginated,round mass,enhancement usually involve only the rim;and two cases of metastatic tumor,which the CT showed a soft-tissue mass heterogeneous attenuation.Conclusion：The histopathlogy features of the malignant tumor arising in the ileocecal area,can be sufficiently manifestated using a 64-slice spiral CT to enhanc the multiplanarreconstruction＇s,maximum intensity projection,which is valuable for a better quality diagnosis.