非肿瘤性阑尾黏液囊肿的MSCT诊断依据分析  

Evaluation of the Diagnostic Value and Manifestations of Multi-slice Spiral CT for Non-neoplastic Appendiceal Mucocele

作　　者：向武昌 李熔基 XIANG Wuchang;LI Rongji(Yunyang County People’s Hospital in Chongqing,Chongqing 404599,China;不详)

机构地区：[1]重庆云阳县人民医院,重庆404599

出　　处：《中外医学研究》2021年第12期61-64,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨MSCT诊断非肿瘤性阑尾黏液囊肿的影像学依据和临床价值。方法:回顾性分析13例被手术及病理确诊的非肿瘤性阑尾黏液囊肿的临床和影像学资料,其中12例为单纯性黏液囊肿,1例为囊肿并黏膜增生,每例患者的病变阑尾影像均通过MSCT扫描及工作站上MPR和CPR重组获得。结果:13例均显示右下腹盲肠附近囊性病变,大小不等。其横断层面图像显示病变呈椭圆形8例,短管样3例,圆形2例;而MPR和CPR图像显示病变呈长管-囊形10例,似‘多籽花生壳’样,长葫芦形2例,长茄子形1例,提示病变符合阑尾管状走向特点。病变阑尾远端呈‘奶嘴样’7例。囊肿壁薄而匀称,囊壁钙化3例,无壁结节,增强时囊壁轻微强化。囊腔内密度相对均匀,含钙乳1例,无完整线样分隔。病变阑尾周围脂肪间隙清晰12例,脂肪浸润1例,未见腹腔积液和腹膜假性黏液瘤。病变阑尾与盲肠的关联方式有头嵌式10例,蒂连式2例,身嵌式1例。结论:MSCT和其图像后处理重建方法能清晰地显示病变阑尾的形态学全貌及其周围结构,非肿瘤性阑尾黏液囊肿的CT表现有一定的形态学特征,初步拟出MSCT诊断本病的定位和定性依据。这有助于提高本病的术前诊断率,也有益于手术方案的制定和并发症的预防。Objective:To explore the imaging basis and clinical value of MSCT in the diagnosis of non-neoplastic appendiceal mucocele (NNAM).Method:The clinical and imaging data 13 cases of NNAM (including 12 cases of simple mucocele and 1 case of mucosal hyperplasia) confirmed by operation and pathology were retrospectively analyzed,and in each case imaging of lesions appendix was obtained by MPR and CPR reconstruction technology on the workstation after MSCT scanning.Result:A total of 13 cases on CT showed cystic lesions of different sizes in the right lower abdomen near cecum.The images of axial section showed these lesions were oval (n=8),short tubular (n=3) and round (n=2),whereas the images of MPR and CPR showed these lesions were long tubular-cystic shape (look like ‘seedy peanut shell’ n=10),long gourd shape (n=2) and long eggplant shape (n=1),which showed the lesions in accordance with the path of appendix.The distal of some lesions appendix were ‘nipple’ shape (n=7).The cystic wall of most lesions were thin and symmetrical,with mural calcification (n=3),without mural nodules,and were slight strengthened in the enhancement.The density of inner composition of most cysts were relatively uniform,with calcification (n=1),without internal lineal separations.The fat space around the lesion appendix was clear (n=12),without free intraperitoneal fluid and pseudomyxoma peritonaei.The contact way of cecum with lesions appendix has been head pressing mode (n=10),the pedicle connected mode (n=2) and body pressing mode (n=1).Conclusion:MSCT and post-processing reconstruction method can display clearly and completely morphologic features of lesions appendix and its surround structure,CT manifestations of NNAM have certain morphologic characteristics.The location and qualitative diagnostic basis of NNAM in MSCT diagnosis was drawn up by our study.Which is helpful for improving the preoperative diagnosis rate of NNAM,and which is conducive to the formation of surgical procedures and the prevention of complication.

关 键 词：阑尾黏液囊肿 非肿瘤性 多层螺旋CT 

分 类 号：R656.8[医药卫生—外科学]