阑尾黏液性肿瘤的超声表现特征分析  

Analysis of the ultrasound characteristics of appendiceal mucinous neoplasms

作　　者：邢艳 徐婷婷 颜丽 XING Yan;XU Tingting;YAN Li(Department of Ultrasound,Zaozhuang municipal hospital,Zaozhuang 277000,China)

机构地区：[1]山东省枣庄市立医院超声科,山东枣庄277000

出　　处：《医学影像学杂志》2025年第2期96-99,共4页Journal of Medical Imaging

基　　金：山东省医药卫生科技项目(编号:202303111229)。

摘　　要：目的探讨超声检查在阑尾黏液性肿瘤(AMN)诊断及鉴别诊断中的价值。方法选取本院经手术病理证实、临床及术前超声检查资料齐全的AMN患者38例,分析其术前临床资料、超声表现及术后病理学特征。结果1)术前超声检查:38例病灶中32例表现为右下腹囊性包块,均为单房,壁不厚,其中30例囊壁部分或全部呈强-弱-强层次表现,2例囊壁菲薄,未见强-弱-强层次表现;21例病灶内呈不均质低或弱回声,3例病灶内见中等回声结节,8例内部呈洋葱皮征。5例表现为阑尾增粗,壁增厚,呈强-弱-强-弱-强层次表现;1例表现为阑尾增粗,局部壁明显增厚,层次不清,壁上可见条状血流信号。38例病灶中1例因阑尾穿孔引起右下腹胶冻样黏液积聚,1例转移至腹膜引起腹膜假黏液瘤;2)术后病理诊断:38例患者均病理证实为AMN,其中2例为黏液腺癌,1例为高级别AMN(HAMN),其余35例为低级别AMN(LAMN)。结论AMN女性多见,超声检查表现有一定特点,最常见的为右下腹单房囊性包块,壁呈强-弱-强层次,内呈低回声或弱回声,超声检查对AMN及其并发症的诊断及鉴别诊断有一定价值。Objective To explore the value of ultrasonography in the diagnosis and differential diagnosis of appendiceal mucinous neoplasms(AMN).Methods This study retrospectively analyzed 38 cases of AMN in Zaozhuang Municipal Hospital.All cases underwent preoperative ultrasound examination and were confirmed by histopathology.The clinical manifestations,preoperative ultrasound findings,and postoperative pathological features were analyzed.Results 1)Preoperative Ultrasonography:Of those 38 cases in this study shown lesions by ultrasonography,32 cases presented as cystic masses in the right lower abdomen,all of which were unilocular with thin walls.Among them,30 cases exhibited a strong-weak-strong layering pattern in part or all of the cyst wall,and 2 cases had a thinner cyst wall without a strong-weak-strong layering pattern.In 21 cases,internal echoes were heterogeneous,appearing as hypoechoic or weak echoes,while,3 cases showed nodules with moderate echogenicity.Additionally,8 cases exhibited an onion skin appearance internally.In 5 cases,the appendices appeared thickened with increased wall thickness,showing a strong-weak-strong-weak-strong layering pattern.In one case,the appendix showed thickening,significant local wall thickening,unclear layering,and linear blood flow signals on the wall.Among the 38 patients,one case had appendiceal perforation,leading to gelatinous accumulation in the right lower abdomen and 1 case developed Pseudomyxoma Peritonei due to metastasis to the peritoneum;2)Postoperative pathological examination results:All 38 patients were confirmed to have AMN,including 2 cases of mucinous adenocarcinoma,1 case of high-grade appendiceal mucinous neoplasms(HAMN),and the remaining 35 cases were low-grade appendiceal mucinous neoplasms(LAMN).Conclusion AMN are more common in females,often presented which often present with right lower abdominal pain,sometimes accompanied by mild tenderness and rebound tenderness.The pathology is mainly LAMN.Ultrasonography has distinct characteristics,and its different ul

关 键 词：阑尾黏液性肿瘤 腹膜假黏液瘤 超声检查 

分 类 号：R735.3[医药卫生—肿瘤] R445.1[医药卫生—临床医学]