阑尾低级别黏液性肿瘤的CT诊断价值

The value of CT in the diagnosis of low-grade appendiceal mucinous neoplasm

目的探讨阑尾低级别黏液性肿瘤(LAMN)的CT诊断价值。方法回顾性分析经手术病理证实32例阑尾黏液性囊性病变的CT表现、临床及病理学资料。按照低度恶性、良性分为两组,统计分析两组的CT特征。结果低度恶性组包括25例LAMN,良性组包括3例单纯黏液囊肿和4例黏液性囊腺瘤。两组病变的平均长径、短径、长/短、腔内密度和囊壁厚度均无显著性差异。LAMN与良性组比较,联合7种CT征象中的任何3个,灵敏度为80%,特异度为71. 4%;7种CT征象包括:囊壁不均匀增厚,囊壁毛糙,囊壁下"双边征"或"假晶状体征",囊壁钙化,囊壁连续性中断,腹盆腔积液和腹膜假黏液瘤(PMP)。结论 LAMN的CT表现多样,可以显示一定的病理特征,联合应用上述7种征象,有助于提高LAMN的诊断及鉴别诊断。

Objective To evaluate the value of CT in diagnosis of low-grade appendiceal mucinous neoplasm（LAMN）.Methods CT findings,clinical data and histological features of 32 cases of appendiceal mucinous cystic lesion confirmed by pathology were retrospectively analyzed. According to the low grade malignancy,benign,they were divided into two groups,and the CT characteristics of the two groups were analyzed statistically. Results Low grade malignant group included 25 cases of LAMN,benign group included 3 cases of simple mucocele and 4 cases of mucinous cystadenoma. There was no significant difference in mean length,short diameter,length/short diameter,intracavitary density and cystic wall thickness between the two groups.Compared with benign group,LAMN combined with any 3 of 7 CT signs had a sensitivity of 80% and a specificity of 71. 4%. 7 kinds of CT signs included： uneven thickening of capsule wall,rough wall, ＂ bilateral sign＂ or ＂ pseudophakic sign＂ under the wall,calcification of capsule wall,capsule wall continuity interruption,abdominal and pelvic effusion and pseudomyxoma peritonei（PMP）. Conclusion The CT findings of LAMN are various and can show certain pathological features. The combined use of the above 7 signs will help to improve the diagnosis and differential diagnosis of LAMN.