摘要
目的通过对阑尾黏液囊肿临床表现、病理基础及影像学检查的分析总结,提高对本病诊断水平。方法总结北京协和医院1985年1月至2004年9月间收治经病理证实的阑尾黏液囊肿患者18例,其中男4例,女14例,男女比率1∶3.5,年龄31～78岁,平均59.8岁,患者中11例行钡灌肠造影检查,其中9例行腹部CT扫描,有1例同时行CT结肠三维重建及仿真内窥镜检查。结果(1)临床表现:8例(44.4%)有右下腹疼痛症状,12例(66.7%)可触及包块。(2)影像学检查:10例钡灌肠显示盲肠末端充盈缺损,呈外压性改变,黏膜无破坏;8例CT显示右下腹囊性包块,75%可见囊壁钙化,1例结肠三维重建及仿真内窥镜可清晰显示病变在盲肠腔内外改变;1例腹膜假性黏液瘤显示腹膜腔大量分隔状黏液腹水。(3)术后病理检查:4例为单纯性黏液囊肿(22.2%),12例为黏液性囊腺瘤(66.7%),2例为黏液性囊腺癌(11.1%)。结论阑尾黏液囊肿具有4种不同的病理学基础,影像学表现有明显特异性,对临床的正确诊断至关重要。
Objective To improve capability of appendiceal mucocele diagnosis via analyzes its clinical, pathological basis and radiological results. Methods Summarize 18 cases with pathological diagnosed appendiceal mucocele in PUMC Hospital since January 1985 till september 2004, including 4 males and 14 females （1： 3.5）, age ranged from 31 to 78yrs old （average 59. 8 years old）. Eleven cases underwent barium enema, in which 9 cases received abdominal CT scanning and 1 case received CT virtual colonography. Results （ 1 ） Clinical results： 8 cases （44. 4% ） had right lower abdominal pain, 12 cases （66.7%） had palpable abdominal mass. （2） Radiological results： barium enema showed extrinsic oppressed filling defect at the end of cecum without destruction of mucosa; CT scanning showed right lower abdominal cystic mass, 75% with cystic wall calcification, massive septal mucous ascites was seen in one case with pseudomyxoma peritonei; CT virtual colonography showed clearly the extracavity and intracavity changes at cecum. （3）Pathological results： simple mucocele （4 cases, 22. 2% ）, mucous cystadenoma （ 12 cases, 66.7%） and mucous cystadenocarcinoma （2 cases, 11.1%） Conclusion There are four pathological types in appendiceal mucocele. Radiological characters of appendiceal mucocele have distinct specificities while its clinical ones not. Radiological procedures are vital for correct clinical diagnosis.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2005年第33期2354-2357,共4页
National Medical Journal of China
