阑尾囊性病变的多层螺旋CT诊断

摘要

Purpose To study the value and manifestations of multi-slice computed tomography (MSCT)in diagnosis of appendiceal cystic lesions. Materials and Methods CT appearances of 58 cases with appendiceal cystic lesions confirmed by surgery and pathology were retrospectively analyzed, including abscess(32 cases), mucinous cyst (12 cases), mucinous cystic adenoma (9 cases) and mucinous cystic adenocarcinoma (5 cases). Results There were significant difference (P< 0.05) of appendiceal abscess, mucinous cyst, mucinous cystic adenoma and mucinous cystic adenocarcinoma in plain MSCT density, enhanced pattern, with or without calcification, celiac planting forming pseudomyxoma and seroperitoneum ascites. No significant difference(P > 0.05) in size, shape, surrounding fat interspace, enhanced degree and metastasis of these four diseases. Conclusion Contrast enhanced MSCT is valuable for diagnosis and differential diagnosis of appendiceal cystic lesions before operation, and would be helpful for treatment options.%目的 探讨多层螺旋CT (MSCT)对阑尾囊性病变的诊断及鉴别诊断价值.资料与方法 收集58例经手术病理证实的阑尾来源囊性病变,包括阑尾脓肿32例、阑尾黏液囊肿12例、阑尾黏液性囊腺瘤9例、阑尾黏液性囊腺癌5例.回顾性分析所有患者的腹盆部MSCT平扫和增强图像.结果 阑尾脓肿、阑尾黏液囊肿、阑尾黏液性囊腺瘤和阑尾黏液性囊腺癌之间在MSCT上平扫密度是否均匀、有无钙化、增强后囊壁及实性部分的强化方式是否均匀、有无腹腔种植形成假性黏液瘤和有无腹盆腔积液方面差异有统计学意义(P＜0.05),而在病变大小、形态、周围脂肪间隙、强化程度和有无脏器转移方面差异无统计学意义(P＞0.05),四种病变两两间比较各有差异.结论 MSCT对阑尾囊性病变的诊断和鉴别诊断,以及术前评估和指导临床合理选择治疗方案有重要价值.