阑尾黏液性肿瘤的CT表现及临床分析  

CT manifestation and clinical analysis of appendiceal mucinous tumor

作　　者：徐达峰 马周鹏[2] 谢一平 王天科[2] 

机构地区：[1]浙江省慈溪市红十字医院放射科,315300 [2]温州医科大学附属慈溪医院放射科,浙江慈溪315300

出　　处：《中国医师进修杂志》2016年第9期846-849,854,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：分析阑尾黏液性肿瘤的CT表现及临床特点，提高诊治水平。方法回顾性分析7例经病理学检查证实的阑尾黏液性肿瘤患者的CT和临床资料。结果7例中黏液性囊腺瘤6例，黏液性囊腺癌1例。1例无明显症状意外发现，3例因急性右下腹疼痛及发热就诊，3例既往有“慢性阑尾炎”病史，其中2例右下腹有肿块，病史1 d至2年。CT平扫均表现为右下腹部单发囊性肿块，最大横径25～208（67±27）mm，6例黏液性囊腺瘤患者囊壁较薄而均匀，厚2.3～3.5 mm，内壁较光整，3例见囊壁钙化；1例黏液性囊腺癌患者囊壁不均匀增厚，3.5～5.7 mm，内壁见小的壁结节。7例囊内黏液较多，CT值14.0～33.5 HU，其中4例囊内见较纤细分隔。CT增强示6例黏液性囊腺瘤患者静脉期囊壁呈轻至中度较均匀强化，1例黏液性囊腺癌患者囊壁及内壁结节呈较明显持续强化。4例肿瘤边界较清晰，3例合并急性炎性反应，周围见渗出模糊影，l例黏液性囊腺癌患者见肠系膜淋巴结肿大。7例均手术治疗，1例黏液性囊腺癌术后20个月随访见腹腔假性黏液瘤种植转移，术后26个月仍带瘤生存；6例黏液性囊腺瘤患者术后随访18～36个月，CT复查未见肿瘤复发及转移。结论阑尾黏液性肿瘤临床缺乏特异性症状及体征，该病预后较好，CT对其诊断有较大价值。Objective To analyze the CT manifestation and clinical characteristics of appendiceal mucinous tumor for improving the diagnostic and therapeutic level. Methods The CT and clinical data of 7 patients with appendiceal mucinous tumor verified by histopathology were retrospectively analyzed. Results Among the 7 cases, mucinous cystadenomas was in 6 cases, and mucinous cystadenocarcinoma was in 1 case. One case had no obvious discomfort;3 cases visited because of pain on right hypogastrium and fever;3 cases had the medical history of＂chronic appendicitis＂, among whom 2 cases had the mass on right hypogastrium which had existed for 1 day or 2 years. The unenhanced CT showed that all of 7 cases had the cystic tumors on right hypogastrium near the cecum, and the maximum traverse diameter was 25-208 （67 ± 27） mm. The cyst walls of mucinous cystadenoma in 6 cases were flimsy, symmetrical, 2.3-3.5 mm thickness and smooth. Three cases had cyst walls calcification; the cyst wall of mucinous cystadenocarcinoma was thick and asymmetrical, and the thickness of cyst wall was 3.5-5.7 mm. Small nodes could be found inside the walls. 7 cases had much mucilage, with CT value 14.0-33.5 HU. Four cases had slight septa. The enhanced CT showed that the cyst walls of mucinous cystadenoma in 6 cases were mild to moderate continuous enhancement during venous phase; the cyst wall and nodes mucinous cystadenocarcinoma was obvious and continuous enhancement. Four cases showed clear boundary, while 3 cases accompanied with acute inflammation showed dim edge. The enlargement of lymphatic nodes could be seen near mesentery in 1 case. All the 7 cases were treated by surgical treatment. One patient who survived after 26 months showed the metastasis＆nbsp;of peritoneal pseudomyxoma after 20 months. The 6 patients with mucinous cystadenoma were followed up for 18 - 36 months, they did not had metastasis or recurrence by CT review. Conclusions Appendiceal mucinous tumor is often short of characteristic in clinical symptom and physical sign,

关 键 词：阑尾肿瘤 体层摄影术 X线计算机 回顾性研究 

分 类 号：R735.36[医药卫生—肿瘤] R730.44[医药卫生—临床医学]