摘要
目的总结结直肠绒毛状管状腺瘤的CT和MRI影像表现,旨在提高术前诊断准确率。方法搜集我院2013年1月~2018年12月经病理证实的结直肠绒毛状管状腺瘤的112例,对其影像学资料进行统计分析。结果112例中病灶位于直肠75例,结肠37例,CT和MRI扫描中病灶形态表现扁平状35例及类圆形38例,其次是分叶状25例及菜花状14例;单发病灶99例,多发13例;病灶呈宽基底与肠壁相连93例,带蒂19例。CT平扫96例呈均匀软组织密度影,增强呈持续性或渐进性不均匀明显强化85例。65例行MRI检查的患者中,平扫呈等T1稍长T2信号60例,增强呈明显不均匀强化55例,DWI呈稍高信号60例,ADC值在1~1.6×10^-3mm^2/s之间58例。结论结直肠绒毛状管状腺瘤多发生于中老年,以直肠多见,单发为主,肿瘤多表现为肠腔内类圆形、扁平状、菜花状或分叶状软组织肿块影,边界清楚,边缘光滑;CT检查平扫呈均匀的软组织密度,增强呈明显持续性或渐进性不均匀强化;MRT平扫表面见长T1长T2信号粘液覆盖,病灶增强呈中度及以上不均匀强化,MRI功能成像DWI呈稍高信号,ADC值常大于1×10^-3mm^2/s。
Objective To summarize the CT and MRI findings of colorectal villous tubular adenoma in order to improve the accuracy of preoperative diagnosis.Methods 112 cases of colorectal villous tubular adenoma confirmed by pathology from 2013 to 2018 in our hospital were collected and their imaging data were analyzed statistically.Results Of the 112 cases,75 were located in the rectum and 37 in the colon.The lesions were flat in 35 cases,lobular in 25 cases,round in 38 cases,and cauliflower in 14 cases in CT and MRI scans.There were 93 cases with wide base connected to the intestinal wall,19 cases with pedicled.CT plain scan showed homogeneous soft tissue density,and enhanced cases showed obvious persistent or progressive heterogeneous enhancement.In 65 cases of MRI,60 cases showed iso-T1 slightly longer T2 signal intensity.55 cases showed obvious uneven enhancement.Conclusion Colorectal villous tubular adenoma mostly occurred in the middle and old age,mainly in rectum,mainly solitary.The tumors were mostly round,flattened,cauliflower or lobulated soft tissue masses,with clear boundary and smooth margin.CT showed homogeneous soft tissue density,obvious persistent or progressive heterogeneous enhancement on enhancement,and CT multiplanar recombination clearly showed the"three-ring"enhancement mode of the lesion and the single tumor"vascular hilus".The surface of MRT was covered with mucus on long T1 and T2 signals,the enhancement of lesions was moderate or above homogeneous enhancement,the DWI of MRI functional imaging was slightly high signal,and the ADC value was usually more than 1.0×10^-3 mm^2/s.
作者
田川
谭静
封俊
张大福
李振辉
高德培
TIAN Chuan;TAN Jing;FENG Jun;ZHANG Dafu;LI Zhenhui;GAO Depei(Department of Radiology, The 3rd Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Kunming 650118, P.R.China)
出处
《医学影像学杂志》
2020年第4期641-644,670,共5页
Journal of Medical Imaging
基金
云南省科技计划项目〔编号:2017FE467(-084)〕。
