阑尾低级别黏液性肿瘤的超声检查与CT诊断

Ultrasound and CT diagnosis of low grade appendiceal mucinous neoplasm

目的 探讨分析阑尾低级别黏液性肿瘤(LAMN)的超声声像图和CT表现特点。方法 选取50例LAMN的临床资料、超声声像图及CT图像,观察并记录病变的特征,如位置、形状、分隔、内部回声/密度(胶冻状、洋葱皮样、强回声/钙化)、腹膜假黏液瘤(PMP)、腹腔积液等,根据有无PMP分为单纯LAMN组和LAMN合并PMP组,比较超声和CT对LAMN的诊断准确率,再将两者结合起来进行进一步分析。结果 单纯LAMN组和LAMN合并PMP组比较,肿瘤位置、形状、分隔、腹腔积液等,差异有统计学意义(P<0.05),肿瘤内部:超声检查(胶冻状、洋葱皮样、强回声)、CT检查(壁强化、钙化)表现等差异无统计学意义(P>0.05),超声诊断LAMN的准确率为36.0%,CT诊断准确率为37.5%,差异无统计学意义(P>0.05),将两者联合应用准确率为62.5%,与单独诊断比较差异有统计学意义(P<0.05)。结论 LAMN的超声声像图和CT图像有一定的特点,掌握其声像图和CT影像学特征,充分利用超声声像图的优势,必要时结合CT影像学特点,有助于提高诊断的准确率。

Objective To analyze the ultrasonic features and CT characteristics of low grade mucinous tumors of the appendix(LAMN).Methods Clinical data,ultrasound images and CT imaging findings of 50 LAMN were analyzed retrospectively.The characteristics of the lesion,such as location,shape,separation,internal echo/density("jelly-like","onion skin-like",strong echo/calcification),peritoneal pseudomyxoma peritonaei(PMP),and abdominal effusion,were observed and recorded in the ultrasound and CT images.According to the presence or absence of PMP,all the samples were divided into two groups,i.e.,single LAMN group and LAMN combined PMP group(LAMN+PMP).The differences were compared for statistical significance.The diagnostic accuracy of ultrasound and CT for LAMN was compared,as well as two methods were combined for further analysis.Results The difference was statistically significant(P<0.05)with tumor location,character,separate and ascites between the single LAMN and LAMN+PMP.There was no statistically significant difference with tumor internalization:ultrasound("jelly-like","onion skin-like"),CT(wall reinforcement,calcification)between the single LAMN and LAMN+PMP.Ultrasonic diagnostic accuracy of LAMN was 36%,CT diagnostic accuracy of LAMN was 37.5%.There was no statistically significant difference with the accuracy of comparison between them.The diagnostic accuracy of LAMN combined ultrasound with CT was 62.5%,which was statistically significant compared with either single method diagnosis.Conclusion LAMN has certain features for ultrasonographic manifestations and CT characteristics.The accuracy of diagnosis can be improved by mastering the characteristics of ultrasonography,taking full advantages of ultrasonography and combining CT imaging characteristics if necessary.