多排螺旋CT多模式重建在阑尾囊性病变中的应用

Application of Multi-Planar Reconstruction with Multi-Slice Spiral CT in Appendix Cystic Lesions

目的探讨多排螺旋CT多模式重建(MPR)在阑尾囊性病变的诊断价值,以期提高临床诊断水平。方法回顾性分析2010年11月至2013年1月的55例阑尾囊性病变患者的临床资料,全部采用多排螺旋CT检查,均进行MPR,观察诊断后在阑尾囊性病变的影像学特点。结果 55例阑尾囊性病变中有阑尾脓肿30例,阑尾黏液囊肿11例,阑尾黏液性囊腺瘤9例,阑尾黏液性囊腺癌5例。多排螺旋CT多模式重建结果显示,4种疾病之间在平扫密度是否均匀、有无钙化、增强后囊壁及实性部分的强化方式是否均匀、有无腹腔种植形成比较差异有统计学意义(P<0.05),而在病变大小、形态、周围脂肪间隙、强化程度和有无脏器转移方面差异无统计学意义(P>0.05)。结论多排螺旋CT多模式重建对阑尾囊性病变的诊断和鉴别诊断、术前评估和指导临床合理选择治疗方案有重要的价值。

Objective To evaluate the diagnostic value of multiple-planar reconstruction （MPR） with multi-slice spiral CT in appendix cystic lesions, in order to improve the level of clinical diagnosis. Methods 55 patients with appendix cystic lesions were analyzed retrospectively. All cases received the multi-slice spiral CT examination and appendix MPR, and the imaging characteristics of cystic lesions were observed. Results There were 30 cases of appendicular abscess, 11 cases of mucocele of the appendix, 9 cases of appendiceal mucous cystadenoma, and 5 cases of appendiceal mucinous cystadenocarcinoma. The MPR showed that the difference of scan density, calcification, enhanced schedule of cystic wall and solid part, intraperitoneal metastases among four groups by pairwise comparison was statistically significant （P〈0.05）; but no significant difference had in the lesion size, type, surroundings fat gap, strengthen degree, and viscera metastasis （P 〉0.05）. Conclusions MPR with multi-slice spiral CT in appendix cystic lesions has important clinical value in the diagnosis of appendiceal cystic lesion and differential diagnosis, preoperative evaluation and guidance of reasonable selection of clinical treatment.