阑尾粘液囊肿的CT诊断

目的: 探讨阑尾粘液囊肿的CT诊断价值.材料和方法: 分析7例阑尾粘液囊肿的CT表现特点及其病理基础.结果: 7例阑尾粘液囊肿5例为囊性包块,2例为软组织密度包块,其密度均匀,CT值6～54Hu,大小在2～9.4cm间,包块周围肠系膜脂肪层清晰,增强扫描5例包块无增强,2例有轻度环形增强.1例合并横结肠套叠,7例均未见腹膜假性粘液瘤.结论: 阑尾粘液囊肿CT表现具有囊性水样密度或软组织密度,密度均匀,增强扫描无增强或囊壁仅有轻度环形增强等特征.     

腹膜腔囊性病变的CT表现

目的：探讨腹膜腔囊性病变的CT诊断及应用价值。方法：对照分析57例腹膜腔囊性病变的CT表现和手术、病理结果。结果：21例腹膜腔囊肿或囊腺瘤、囊腺癌CT均表现为边界清晰的囊性或囊实性包块,7例肠系膜囊肿发现囊肿与肠系膜根部相连。5例腹膜腔假性黏液瘤则在肝脏前、后间隙和结肠下间隙见多个有分隔状囊性肿块。3例腹膜腔囊性间皮瘤局限于下腹腔,壁稍厚,有强化。4例腹膜腔淋巴管瘤位于胃脾肾间隙和胃肝间隙,5例腹膜腔血肿均有外伤史,表现为上腹部器管间隙内边缘清晰的囊性包块。12例腹膜腔脓肿均有腹部手术和术后发热史。结论：CT能清晰地显示腹膜腔囊性病变的部位、形态和范围,对临床诊断和治疗有重要价值。     

腹膜后囊性淋巴管瘤的CT诊断

囊性淋巴管瘤又称为囊性水瘤 ,最常见于颈部 ( 75 % ) ,其次为腋部 ( 2 0 % ) ,发生于腹膜后少见。笔者对我院 1995～ 2 0 0 3年经手术病理证实的 6例腹膜后囊性淋巴管瘤的CT特征进行回顾性分析。1　材料与方法6例中 ,男 4例 ,女 2例。年龄 16～ 63岁 ,平均 41岁。临床表现 :4例无症状 ,2例表现为腹痛、腹胀 ,2例触诊可摸到包块。全部病例经手术病理证实。6例均行CT平扫及增强扫描 ,采用SIEMENSSo matomART及GEHispeedNX/i 2种机型 ,横断面扫描 ,层厚10mm ,层距 10mm ,窗宽 15 0HU ,窗位 5 0HU ,螺旋扫描pitch1.5 ,CT增强对比剂…     

胰腺实性-假乳头状瘤的CT诊断价值

目的:探讨CT对胰腺实性-假乳头状瘤的诊断价值.方法:回顾分析经手术、病理证实的6例胰腺实性-假乳头状瘤的CT表现和诊断.结果:6例肿瘤位于胰头2例,胰体尾部4例.6例瘤体均为囊、实混合性,增强后实质部分均有强化,囊性部分无强化.结论:胰腺实性-假乳头状瘤CT表现有一定特征,CT检查对其诊断与鉴别诊断具有重要价值.     

腹膜后副神经节瘤的临床及CT表现与病理对照研究

目的:探讨腹膜后副神经节瘤的临床表现及CT诊断价值。方法:回顾性分析有完整病历及CT资料、经手术病理证实的腹膜后副神经节瘤27例,将临床及CT表现与病理学结果进行对照分析。结果:临床表现:有高血压症状10例,无高血压症状但术中出现血压波动6例,无高血压及术中血压波动11例。CT表现:肿瘤多位于腹中线大血管周围(19个病灶),并多大于5cm(21个病灶),增强CT表现为实性、明显强化,常伴有囊变或坏死。临床表现与病理对照:嗜铬性副神经节瘤16例,有高血压症状10例,另外6例术中有血压波动;非嗜铬性副神经节瘤11例,无任何症状6例,腹部包块4例,血尿1例。CT表现与病理对照:良性肿瘤边缘光整,病灶内囊变区内壁光整,边界清楚;恶性肿瘤形态不规则,"囊变区"不规则,边界不清楚。CT诊断正确率为88.9%,误诊11.1%。结论:临床症状结合增强CT表现在术前对大多数腹膜后副神经节瘤能做出正确诊断。     

胰腺假乳头状囊性瘤的CT诊断

目的:探讨胰腺假乳头状囊性瘤的CT表现特征。方法:回顾性分析经手术及病理证实的9例胰腺假乳头状瘤的CT表现。结果:9例中,囊性结构为主5例,囊、实结构比例近似3例,实性结构为主1例。CT平扫病灶呈类圆形低密度团块影;增强扫描,实性部分明显强化,囊性部分各期均无强化。结论:胰腺假乳头状囊性瘤CT表现具有一定特征性,可做出诊断与鉴别诊断。     

女性结核性盆腔炎CT诊断

目的:探讨女性结核性盆腔炎的CT表现与鉴别诊断.材料和方法:回顾性分析14例经手术或穿刺病理证实的女性结核性盆腔炎的CT表现和临床资料.结果:CT表现为:①9例盆腔包块,其中囊性包块4例,实性1例,囊实混合性4例;②9例盆腔脏器同腹膜广泛粘连;③8例盆腹腔积液,其中6例为包裹性;④3例病灶内钙化;⑤4例盆腹腔淋巴结增大;⑥4例双侧附件软组织增厚;⑦6例腹膜、肠系膜、大网膜增厚、强化;⑧1例直肠壁和乙结肠肠壁不规则增厚.结论:盆腔囊性、囊实性包块和包裹性积液及盆腔广泛粘连是结核性盆腔炎最常见的CT表现,并非特异性征象.病灶内钙化和盆腔淋巴结囊性肿大是支持结核性盆腔炎的重要辅助征象.当CT检查女性盆腔肿块时,发现可疑炎性包块并与周围组织有明显粘连、多脏器累及倾向,或发现盆腔积液呈包裹性时,应进一步结合有关临床病史及实验室报告,结核性盆腔炎作为必要的鉴别诊断,不应忽视.     

腹膜假性黏液瘤的CT诊断

目的:认识和提高腹膜假性黏液瘤的CT表现及诊断.方法:回顾性分析16例经病理或细胞学检查证实的腹膜假性黏液瘤的CT和临床表现.结果:腹膜假性黏液瘤是以黏液性腹水为特征,临床主要表现为腹胀、腹块等.依据CT表现不同可分为弥漫性和局限性两种类型,主要CT表现包括腹水内密度不均匀8例,肝脾表面黏液样结节10例,多发分隔的囊性病变5例和网膜增厚或"网膜饼"征6例.结论:典型的CT表现可以诊断腹膜假性黏液瘤,CT检查可为临床治疗的选择和改善预后提供有价值的信息.     

螺旋CT对颈部囊性淋巴管瘤的诊断价值

淋巴管瘤(lymphangioma)是胚胎发育过程中某些部位的原始淋巴囊与淋巴系统隔绝后所发生的肿瘤样畸形,是淋巴管内皮细胞增殖所形成的一种少见的先天性良性错构瘤。囊性淋巴管瘤是淋巴管瘤中的一种类型,常见于儿童,好发于颈面部。本文回顾性分析我院经手术病理证实的颈部囊性淋巴管瘤的螺旋CT表现,评价螺旋CT对本病的诊断价值,提高对本病的认识和诊断水平。1材料与方法本文收集我院2003~2005年间经手术病理证实的颈部囊性淋巴管瘤15例,其中男9例,女6例,年龄6月~55岁,平均18·3岁,10岁以下者8例。临床表现为颈部局部无痛性包块,部分病例包块…     

胰腺实性假乳头状瘤的CT诊断

目的分析胰腺实性假乳头状瘤的CT诊断价值,以提高对该病的认识及诊断水平。方法回顾性分析6例经手术及病理证实的胰腺实性假乳头状瘤的临床资料及CT表现。结果胰腺实性假乳头状瘤好发于13～45岁年轻女性。6例肿瘤,位于胰头2例,胰尾4例,肿瘤体积较大,6例瘤体均为囊、实混合性,实性为主4例,囊性为主2例,2例肿瘤见线条状及斑点状钙化,增强扫描实性成分呈中度强化,囊性成分无强化,瘤体包膜较完整,边缘清楚。不伴有胆总管及胰管扩张。结论胰腺实性假乳头状瘤具有特征性的CT表现及临床表现。     

CT in pseudomyxoma peritonei: a review of 17 cases

AIM: To describe the computed tomography (CT) findings in pseudomyxoma peritonei. MATERIALS AND METHOD: Two observers independently and retrospectively reviewed the CT images of 17 consecutive patients (nine women, eight men, mean age 53 years) with histologically proven pseudomyxoma peritonei. RESULTS: Six patients had small volume disease where pseudomyxoma peritonei was present in focal collections in the peritoneal cavity. Eleven had large volume disease that completely, or almost completely, filled the peritoneal cavity. Pseudomyxoma peritonei is characterized by low attenuation mucinous ascites on CT. Areas of high attenuation, septae and calcification are seen more commonly within it as the volume of disease increases. The pattern of accumulation of pseudomyxoma peritonei follows the normal flow of peritoneal fluid. It initially seeds at sites of relative stasis and as large volume disease develops it fills the remaining spaces in the peritoneal cavity and pressure effects dominate imaging. Pseudomyxoma peritonei may extend into hernial orifices or the pleural cavity. CONCLUSION: Pseudomyxoma peritonei is difficult to diagnose clinically. However, the pattern of accumulation of disease is predictable and can be recognized on CT.     

Peritoneal pseudomyxoma. Diagnostic role of CT and ultrasonics

Pseudomyxoma peritonei is an uncommon disorder, usually the sequelae of mucocele or mucinous adenocarcinoma of the appendix or mucinous cistoadenocarcinoma of the ovary. Two cases of pseudomyxoma peritonei were examined by ultrasound and one case by CT. US revealed, in a case, multiple echogenic small masses scattering on the peritoneal surface or floating in ascites. CT showed, in the second case, a huge mass consisting of a low attenuation material with internal septation. Also a perforation of intestinal loops in the mass was demonstrated. CT and US appearance of pseudomyxoma peritonei in our experience and in previously reported cases are discussed.     

Imaging of mucocoele of the appendix with emphasis on the CT findings: a report of 10 cases

AIM: Mucocoele of the appendix denotes an obstructive dilatation of the appendiceal lumen due to abnormal accumulation of mucus. It is sometimes associated with pseudomyxoma peritonei, which predicts a malignant origin. We present the CT findings and additional imaging studies of 10 patients with neoplastic appendiceal mucocoele and discuss the clinical implications. MATERIALS AND METHODS: Abdominal CT findings from 10 patients with appendiceal mucocoele were reviewed. Barium enema, US and MRI were additionally performed in three patients. There were five men and five women aged 45-80 years. Special attention was directed to the shape and nature of the mass, its relation to the caecum and the presence of ascites or peritoneal implants, as well as possible additional ovarian tumours in female patients. RESULTS: The mucocoele was an incidental finding in five patients. They were either spherical or elongated cystic lesions, attached to the wall of the caecum, six of them with mural calcification. Ascites were present in six patients and hypodense large peritoneal implants representing pseudomyxoma peritonei in four. Pathologically the series included five cases of cystadenoma (in one, a malignant pseudomyxoma peritonei subsequently developed), four cases of cystadenocarcinoma and one villous adenoma (this patient later developed pseudomyxoma peritonei). Pseudomyxoma peritonei was found in five cases. Three women had associated ovarian cystic tumour. CONCLUSION: The appearance of an appendiceal mucocoele is quite characteristic and can be diagnosed on CT. CT can also depict additional findings suggesting pseudomyxoma peritonei. In women with an appendiceal mucocoele the ovaries should be examined closely for cystic tumour and vice versa.     

Calcification of pseudomyxoma peritonei following intraperitoneal chemotherapy: CT demonstration

Pseudomyxoma peritonei is essentially mucinous ascites, resulting from the intraperitoneal rupture of a malignant mucinous lesion with seeding of peritoneal surfaces. We report a case of pseudomyxoma peritonei from a perforated mucinous adenocarcinoma of the appendix in which radiographically demonstrable punctate calcifications developed during the course of intraperitoneal chemotherapy.     

腹膜假性粘液瘤的临床病理与影像表现分析

目的:探讨腹膜假性粘液瘤的临床影像学表现及病理组织学特征,提高对本病的鉴别诊断水平。方法:选取13例经手术及病理证实的腹膜假性粘液瘤,全部病例均行腹部CT检查,分析其两种临床病理分型(良性DPAM和恶性PMCA)的影像学表现。结果:两型腹膜假性粘液瘤有部分共同的CT表现,比如凝胶状腹水、肝脾边缘扇贝形压迹、肠系膜的浸润性改变、实质器官内浸润性病灶,以及腹膜粘液团在两型均可见到,不同的征象在于大量粘液蛋白性腹水和粘液团块中的钙化更多见于DPAM,网膜饼、淋巴结病变、网膜种植性团块以及原发病灶的显示更多见于PMCA。DPAM常常没有网膜饼形成,但常可见典型的肝脏边缘压迹。结论:两型腹膜假性粘液瘤的影像学表现各具有一定的特征性,充分认识其CT征象的不同有利于放射诊断医师作出正确诊断。     

腹膜假性黏液瘤的CT征象及其与免疫组化的关系

目的:通过分析腹膜假性黏液瘤(pseudomyxoma peritonei,PMP)的CT资料,提高对本病CT征象的认识。方法:回顾性分析52例临床确诊的PMP患者的临床和影像资料,总结CT影像特点及与细胞角蛋白(cytokeratins,CK)和上皮膜抗原(epithelial membrane antigen,EMA)的关系。结果:52例患者均表现为全腹腔及盆腔积液,37例可见明显多发腔隔形成,43例可见网膜饼形成,52例见肝脏侵犯,40例见脾脏侵犯,30例可见明显扇贝征,3例出现腹壁侵犯,14例出现钙化灶。CK阳性组28例,12例见扇贝征;CK阴性组15例,12例见扇贝征。EMA阳性组13例,9例见扇贝征;EMA阴性组24例,8例见扇贝征。CK、EMA的阳性组与阴性组在扇贝征分布方面差异具有统计学意义;而在其他CT征象(游离积液、腔隔、网膜饼征)上,差异均无统计学意义。结论:PMP的CT征象具有一定的特征性,扇贝征与CK、EMA可能有一定的相关性。     

Imaging findings of urachal mucinous cystadenocarcinoma associated with pseudomyxoma peritonei

Pseudomyxoma peritonei is an uncommon neoplastic condition in which gelatinous fluid-like materials are observed in the peritoneal cavity caused by the dissemination of mucinous adenocarcinoma. Although ruptured appendiceal mucocele is the most common cause, tumors arising from other organs may also cause pseudomyxoma peritonei. We report the imaging findings of an extremely rare case of urachal mucinous adenocarcinoma associated with pseudomyxoma peritonei on computed tomography and magnetic resonance imaging with histopathologic correlation.     

腹膜假性黏液瘤CT诊断(附21例报告)

目的:探讨腹膜假性黏液瘤的CT表现,提高对本病的认识.方法:搜集经手术、病理证实的腹膜假性黏液瘤21例,回顾性分析其CT表现.结果:21例中原发瘤恶性8例,其中卵巢黏液囊腺癌3例,阑尾黏液囊腺癌4例,结肠黏液腺癌1例;良性13例,其中阑尾黏液囊腺瘤4例,阑尾黏液囊肿2例,卵巢黏液囊腺瘤6例,胰腺黏液囊腺瘤1例.CT平扫见肝脾等实质脏器边缘扇贝样或结节状压迹,腹腔不规则囊实性肿块,CT值19.9～25.8 HU;脏器周围、网膜间隙、腹腔、盆腔见大量黏液性腹水,CT值10～15 HU;腹膜增厚,厚度1.0～2.0 cm;增强扫描显示囊实性病变仅见囊壁、网膜、腹膜轻度强化,囊内病灶无明显强化.结论:腹膜假性黏液瘤CT表现具有一定的特征,是诊断腹膜假性黏液瘤的重要方法.