多层螺旋CT鉴别低度与高度恶性阑尾原发性肿瘤的价值  

The value of multi-slice spiral CT in differentiating low-grade and high-grade appendiceal primary tumors

作　　者：田茂衡 印隆林 印培源[4] 刘一铭 李谋 TIAN Mao-heng;YIN Long-lin;YIN Pei-yuan;LIU Yi-ming;LI Mou(Department of Radiology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Department of Radiology,Sichuan Academy of Medical Sciences&Sichuan Provincial People′s Hospital,Chengdu 610072,China;Institute of Radiation Medicine,Sichuan Academy of Medical Sciences&Sichuan Provincial People′s Hospital,Chengdu 610072,China;Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]西南医科大学附属医院放射科,四川泸州646000 [2]四川省医学科学院·四川省人民医院放射科,四川成都610072 [3]四川省医学科学院·四川省人民医院放射医学研究所,四川成都610072 [4]成都医学院临床医学院,四川成都610500

出　　处：《实用医院临床杂志》2023年第3期153-157,共5页Practical Journal of Clinical Medicine

基　　金：四川省科技厅重点研发项目(编号:23ZDYF1685);四川省干保局普及应用项目(编号:川干研2023-215);四川省科技厅重点研发项目(编号:2021YF50375)。

摘　　要：目的探讨多层螺旋CT(MSCT)鉴别低度恶性和高度恶性阑尾原发性肿瘤的价值。方法回顾性分析58例经病理证实的阑尾原发恶性肿瘤患者的影像特征,根据手术病理结果将其分为低度恶性与高度恶性组,比较两组病例MSCT特征的差异性。结果58例阑尾原发恶性肿瘤中,低度恶性组42例(低级别黏液性肿瘤)、高度恶性组16例(神经内分泌瘤4例、腺癌6例、高级别黏液性肿瘤2例、低级别黏液性肿瘤伴腹膜假性黏液瘤4例)。两组阑尾原发恶性肿瘤的MSCT特征包括肿瘤的边界、成分、强化以及周围淋巴结显示、是否伴发腹腔积液,组间比较差异均有统计学意义(P<0.05);MSCT评价阑尾原发恶性肿瘤侵袭性的准确率、灵敏度、特异度、阳性预测值、阴性预测值分别为0.793、0.881、0.563、0.841、0.643。结论MSCT能在术前较准确显示阑尾原发恶性肿瘤的特征并评价其侵袭性,指导临床制定更精准的治疗方案。Objective To explore the value of multi-slice spiral CT(MSCT)in differentiating low-grade and high-grade appendiceal primary tumors.Methods The imaging features of 58 patients with primary malignant tumors of the appendix confirmed by pathology were retrospectively analyzed.According to the surgical and pathological results,the patients were divided into a low-grade malignant group and a high-grade malignant group.The differences in MSCT characteristics were compared between the two groups.Results Among the 58 patients,42 were low-grade malignant tumors(low-grade mucinous tumor),and 16 were high-grade malignant tumors.Among the 16 patients with high-grade malignant tumors,4 were neuroendocrine tumor,6 were adenocarcinoma,2 were high-grade mucinous tumor and 4 were low-grade mucinous tumor with peritoneal pseudomucinous tumor.The MSCT characteristics of the primary malignant tumors of the appendix included tumor size,location,border,composition,enhancement and surrounding lymph node display as well as whether it was accompanied by ascites in the two group.The differences between the two groups were statistically significant(P<0.05).For MSCT evaluating the invasiveness of the tumors,the accuracy was 0.793.The sensitivity was 0.881.The specificity was 0.563.The positive predictive value was 0.841 and the negative predictive value was 0.643.Conclusions MSCT can accurately show the features of primary appendiceal malignant tumors before operation and evaluate their aggressiveness.Therefore,it can guide the clinical development of more accurate treatment plan.

关 键 词：多层螺旋CT 阑尾肿瘤 恶性程度 鉴别诊断 

分 类 号：R735[医药卫生—肿瘤] R656[医药卫生—临床医学]