阑尾低级别黏液性肿瘤的MSCT表现与病理对照

MSCT findings of low grade mucinous tumors of appendix

目的:总结分析阑尾低级别黏液性肿瘤(LAMN)的多层螺旋CT(MSCT)表现特征。方法:回顾性分析手术病理证实的28例LAMN患者临床资料和MSCT表现,其中6例平扫,其余22例包括平扫和三期增强扫描。结果:28例LAMN中,肿瘤位于右下腹阑尾区21例,位于中腹部3例,位于盆腔4例。18例呈管状,8例椭圆形,2例不规则形。肿瘤平均长径(5.42±2.31)cm,平均短径(2.42±1.35)cm。囊腔平扫平均CT值(13.25±6.78)HU,12例囊壁均匀薄壁,16例壁厚薄不均匀。14例囊壁伴有钙化,呈点状、线状或蛋壳样,5例囊壁有结节。8例伴肿瘤周围脂肪间隙模糊,9例回盲部周围散在淋巴结显示,4例伴有肿瘤周围局限性积液,3例肿瘤破裂形成腹膜假性黏液瘤,4例发生局限性肠梗阻。22例增强扫描囊内均无强化,7例囊壁未见强化,5例囊壁及壁结节轻度强化,4例囊壁及分隔轻度强化,6例囊壁轻度或中度强化。结论:LAMN临床虽然少见,但MSCT表现具有一定特征性,术前运用MSCT平扫及增强检查可提高诊断准确性。

Objective:To investigate the multi-slice computed tomography(MSCT)findings of low grade appendiceal mucinous neoplasm(LAMN).Methods:28 cases of LAMN confirmed by pathology were collected,of which,6 cases underwent plain CT scan and the rest underwent MSCT plain scan and three-phase enhanced scan.The clinical and CT data were retrospectively analyzed.Results:Among the 28 cases of LAMN,21 cases were located in the appendix area of the right lower quadrant,3 cases in the middle abdomen,and 4 cases in the pelvic cavity.18 cases were tubular,8 cases were oval and 2 cases were irregular.The average long diameter of the 28 tumors was(5.42±2.31)cm and the average short diameter was(2.42±1.35)cm.Mean CT value of cystic was(13.25±6.78)HU in plain scan.12 cases had uniform and thin wall,and the other 16 cases had uneven wall thickness.14 cases had calcification,which was punctate,linear or eggshell like.5 cases had nodules in the capsule wall.8 cases had blurred fat space around the tumor,9 cases showed scattered lymph nodes around the ileocecal part,4 cases had localized effusion around the tumor,3 cases had ruptured tumor forming PMP,and 4 cases had localized intestinal obstruction.Among the 22 cases of enhancement,MSCT showed no enhancement in the capsule,7 cases had no enhancement in the capsule wall,5 cases had mild enhancement in the capsule wall and wall nodules,4 cases had mild enhancement in the capsule wall and septum,and 6 cases had mild or moderate enhancement in the capsule wall.Conclusion:Although LAMN is rare in clinic,MSCT findings have certain characteristics.It can improve the diagnostic accuracy of preoperative diagnosis.