原发性阑尾肿瘤的CT诊断

目的评价原发性阑尾肿瘤的CT表现.方法对24例经手术和病理证实的原发性阑尾肿瘤病人的腹部CT进行回顾性分析,记录阑尾直径、阑尾壁厚度、阑尾腔内改变及阑尾浆膜面改变等,并注意盲肠、末段回肠、阑尾周围脂肪改变和腹腔淋巴结肿大等.结果24例原发性阑尾肿瘤为黏液性腺瘤(n=11)、黏液性腺癌(n=5)、结肠型腺癌(n=4)和类癌(n=4).阑尾最大直径为12 mm～52 mm,19例(79%)最大直径超过15 mm;阑尾壁最大厚度3 mm～16 mm,13例(58%)在5 mm以上;10例(42%)可见阑尾腔内肿块阑尾内壁不规则隆起,1例(4%)可见阑尾表面外突性肿块.使用阑尾肿块/囊状扩张/直径大于15 mm的综合标准诊断率为92%.如附加阑尾壁厚度大于5 mm的标准则诊断率为100%.结论CT是发现阑尾肿瘤的有效方法,表现为阑尾肿块、阑尾腔囊状扩张、直径大于15 mm和壁厚超过5 mm.

CT diagnosis of primary appendiceal neoplasms

Objective To evaluate the CT findings of primary appendiceal neo pl asm (PAN).Methods Abominal CT findings in 24 patients with surgically and pathol ogically proved PAN were analyzed retrospectively.The appendiceal dimaeter,wall thickness and intra-and extraluminal mass were recorded for each case,simultane ously,the findings related to cecum,distal ileum,periappendiceal fat and intraa bdominal lymph nodes were noted.Results The pathologic patterns of PAN in all pa tients included mucinous adenoma(n=11),mucinous adenocarcinoma(n=5),coronic type adenocarinoma(n=4),and carcinoid tumor(n=4).The maximal appendiceal diameters were 12-52 mm,with 19(79 %) of whicch exceeding 15 mm .The maximal wall thickn esses were 3-16 mm,with 13(58 %) of which exceeding 5 mm.Intraluminal mass and irregular mural elevation were found in 10 cases while extruded mass in 1 case. By the combined criterion of appendiceal mass/cystic luminal dilatation/threshol d maximal diameter of 15 mm,92 %of the neoplasms were diagnosed as appendiceal tumor.If additional criterion of wall thicker than 5 mm was applied,all of cases could be diagnosed.Conclusion CT is an effective method for detecting appendice al tumor because it can clearly reveal the appendiceal mass,cystic luminal dilat ation,maximal diameter of more than 15 mm,and wall thickness of more than 5 mm.