直肠黏液腺癌的CT及MRI表现  

CT and MRI features of rectal mucinous adenocarcinoma

作　　者：陈昭辉 史灵雪 刘硕[3] 郭昊 CHEN Zhaohui;SHI Lingxue;LIU Shuo;GUO Hao(Department of Radiology,Jilin Provincial People’s Hospital,Changchun 130021,China)

机构地区：[1]吉林省长春铁北监狱医院放射科,吉林长春130102 [2]吉林省人民医院放射科,吉林长春130021 [3]吉林大学中日联谊医院放射科,吉林长春130033 [4]吉林省吉林市人民医院放射科,吉林长春132001

出　　处：《中国中西医结合影像学杂志》2022年第4期376-379,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨直肠黏液腺癌的CT及MRI特征。方法:回顾性分析经手术病理证实的104例直肠黏液腺癌患者的临床及影像资料。结果:104例中,76例肠壁呈环形增厚,19例呈局部增厚,9例呈息肉样肿块。肿瘤距肛门2.1~14.8 cm,病灶长度1.9~10.2 cm,肠壁厚度0.7~5.2 cm。CT平扫104例病灶呈不均匀低密度影,其中18例可见点片状钙化。81例行CT增强扫描,其中43例呈轻度强化,23例呈中度强化,15例呈明显强化;静脉期均可见不同范围的低密度欠强化区。104例病灶T_(1)WI多呈等或稍低信号、T_(2)WI呈混杂高信号,82例病灶的高信号区面积占肿瘤面积的50%以上。DWI多呈混杂高或稍高信号,ADC图以高信号为主,高信号区平均ADC值约1.52×10^(-3) mm^(2)/s。肠周脂肪间隙浸润患者82例,69例伴周围淋巴结转移,18例出现腹膜转移。结论:直肠黏液腺癌的CT及MRI表现具有一定特征性,能够为该病的诊断及预后评估提供依据。Objective:To explore the CT and MRI features of mucinous adenocarcinoma of the rectum.Methods:A retrospective analysis was performed on 104 cases of mucinous adenocarcinoma of the rectum confirmed by surgery and pathology.Results:In 104 cases of rectal mucinous adenocarcinoma,the intestinal wall of 76 patients showed annular thickening,19 showed local thickening,and 9 showed a polypoid mass.The tumor distance from the anus was 2.1~14.8 cm.The lesion involvement length was 1.9~10.2 cm.The intestinal wall thickness was 0.7~5.2 cm.On the plain CT scan,the lesions showed uneven low-density shadows,and in 18 cases,spot-like calcification was observed.Among the 81 patients who underwent enhanced CT scans,43 showed mild enhancement,23 showed moderate enhancement,and 15 showed obvious enhancement.All the lesions showed low-density and under enhancement areas in different ranges.Lesions of 104 cases on T_(1)WI showed isostatic or slightly lower signals,while T_(2)WI showed mixed high signals.In 82 cases,the high signal area of the lesions was≥50%of the tumor area.DWI usually showed mixed high or slightly high signals.ADC images showed mainly high signals,and the average ADC value in the high signal area was approximately 1.52×10^(-3) mm^(2)/s.There were 82 patients with perienteral fat space infiltration,69 with peripheral lymphatic metastasis,and 18 with peritoneal metastasis.Conclusions:The CT and MRI findings of rectal mucinous adenocarcinoma have certain characteristics,which are helpful for the diagnosis and prognosis of the disease.

关 键 词：直肠肿瘤 腺癌 黏液 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.37[医药卫生—肿瘤]