阑尾黏液性肿瘤影像学表现及病理相关性研究

目的：探讨阑尾黏液性肿瘤的影像学表现及其病理相关性,提高对该病的认识和诊断准确性。方法回顾性分析16例经手术病理证实的阑尾黏液性肿瘤影像资料,其中包括2例黏液性囊腺瘤,10例低级别黏液性肿瘤(LAMN)和4例黏液性囊腺癌,分析病变影像学表现及病理相关性。结果黏液性囊腺瘤多表现为长椭圆形或条形液性低密度,边界清晰,壁完整,密度均匀。黏液性囊腺癌多表现为不规则形囊实性肿块,边界不清,结节状及分隔强化,常侵犯邻近肠管；部分黏液性囊腺癌易伴发腹膜假性黏液瘤(PMP)及腹腔种植转移。LAMN介于黏液性囊腺瘤与黏液性囊腺癌之间,多数病例表现与黏液性囊腺瘤相似,部分病例与黏液性囊腺癌表现相似。结论阑尾黏液性肿瘤影像学表现多样,部分病例影像学表现具有一定特征性,CT 及 MRI 检查对该病的诊断具有较大价值。

Appendiceal mucinous neoplasms:imaging features and correlation with pathology

Objective To explore the imaging features of appendiceal mucinous neoplasms and their correlation with the pathology results.Methods The imaging data of 1 6 patients with histopathology proved appendiceal mucinous neoplasms were analyzed retrospectively including mucinous adenoma in 2,low-grade appendiceal mucinous neoplasm (LAMN)in 10,and appendiceal adenocarcinoma in 4. The imaging features were correlated with the result of pathology.Results Mucinous cystadenoma was usually a long oval or strip low density cystic structures with smooth capsule wall and well defined border.Mucinous adenocarcinoma usually presented as a irregular solid-cystic mass with ill-defined border and nodular or separation enhancement.The tumor often infiltrated adjacent bowels,and some of them were accompanied with pseudomyxoma peritonei (PMP)and abdominal implantation metastasi.LAMN had low potential malignancy.The imaging features were between cystadenoma and cystadenocarcinoma.Most cases were similar to mucinous cystadenoma, and some were like to mucinous cystadenocarcinoma.Conclusion The appendiceal mucinous neoplasms have various imaging manifestations. Some cases show some CT and MRI characteristics,which are benefit to the diagnosis of these diseases.