胰腺囊腺瘤与囊腺癌的CT诊断价值

目的：探讨胰腺浆液性囊腺瘤、黏液性囊腺瘤或囊腺癌具有鉴别诊断意义的CT征象。方法：回顾性分析经手术及病理证实的17例胰腺浆液性囊腺瘤、黏液性囊腺瘤或囊腺癌的CT表现,总结其特征性表现。结果：17例中浆液性囊腺瘤7例,黏液性囊腺瘤8例,黏液性囊腺癌2例。浆液性囊腺瘤呈分叶状轮廓者占85.7%（6/7）,均为多囊状结构,其中最大囊直径小于2cm者占71.4%（5/7）,出现病灶中心钙化者1例;黏液性囊腺瘤或囊腺癌位于胰体尾部者占90%（9/10）,无分叶状轮廓,单囊者占80%（8/10）,最大囊直径大于2cm者占90%（9/10）。囊内乳头状突起,囊壁厚薄不均,病灶内实性成分增多,多提示恶性。结论：胰腺浆液性囊腺瘤与黏液性囊腺瘤或囊腺癌的CT表现明显不同,多可做出诊断与鉴别诊断,但对于不典型表现的诊断存在困难。     

胰腺黏液性囊腺瘤或囊腺癌的CT诊断及鉴别诊断

胰腺黏液性囊腺瘤或囊腺癌是最常见的胰腺囊性肿瘤,几乎仅见于女性,约占胰腺肿瘤的1%~2%[1].随着影像设备的快速发展,胰腺黏液性囊腺瘤和囊腺癌的检出率有所提高,本文收集本院7例病理证实的胰腺黏液性囊腺瘤和囊腺癌患者的CT资料加以分析,希望能提高对胰腺黏液性囊腺瘤和囊腺癌的认识.     

肝胆管及胰腺粘液性囊腺肿瘤的CT影像与病理对照研究

目的：研究肝胆管或胰腺粘液性囊腺肿瘤的CT表现。方法：选取本院1989年1月～2002年6月间经手术病理证实的肝胆管或胰腺粘液性囊腺肿瘤12例，对其CT图像进行回顾性研究。结果：肝胆管囊腺肿瘤5例，其中囊腺瘤3例，囊腺癌2例；胰腺囊腺肿瘤7例，其中囊腺瘤4例，囊腺癌3例。钙化2例，腹腔及／或腹膜后淋巴结肿大2例，伴有其他脏器转移1例。结论：肝胆管或胰腺粘液性囊性肿瘤的CT表现具有一定的特征性，并为临床治疗提供指导。     

卵巢囊腺瘤与囊腺癌的CT诊断

目的探讨CT对卵巢囊腺瘤与囊腺癌的诊断价值。方法对32例经手术病理证实的卵巢良恶性肿瘤患者包括良性卵巢囊腺瘤10例,交界性卵巢囊腺瘤4例以及恶性卵巢囊腺癌18例均经腹部CT扫描,对所有患者的CT表现进行回顾性分析。结果10例11个卵巢囊腺瘤中浆液性囊腺瘤7个,其中,单房5个,密度均匀;黏液性囊腺瘤4个,多房为主,密度不均,内见大小不等的子囊。交界性（4个）和恶性（28个）卵巢肿瘤32个,囊壁及分隔厚薄不均,不同程度强化,多有壁结节或肿块成分。结论卵巢囊腺瘤常表现为I型,囊腺癌以Ⅱ型常见。CT能很好显示卵巢肿瘤的形态特征,在鉴别卵巢囊腺肿瘤良恶性方面有一定价值。     

Biliary cystadenoma and cystadenocarcinoma: some unusual features

Biliary cystadenoma and cystadenocarcinoma are rare tumours which have a good prognosis after complete surgical removal. Correct pre-operative diagnosis depends on the imaging characteristics of the tumours. We have observed some unusual features including multifocal tumours with attachment to other abdominal organs, tumour presenting as cholangitic abscess, and distant metastasis after apparently complete resection by hemihepatectomy.     

Leiomyoma of the ovary mimicking mucinous cystadenoma

We present a case of ovarian leiomyoma of a 46-year-old woman with a history of a palpable lower abdominal mass. A multiloculated multiseptated mainly cystic mass in the left adnexa on computed tomography (CT) was initially considered to be an ovarian mucinous cystadenoma. This mass, however, was proved to be a left ovarian vascular leiomyoma on the surgical pathology.     

阑尾黏液性囊腺瘤的CT表现

目的:探讨阑尾黏液性囊腺瘤的CT诊断价值。方法:回顾性分析经手术病理证实的6例阑尾黏液性囊腺瘤CT平扫和增强表现。结果:6例中4例阑尾囊状膨胀,4例密度不均匀,3例有曲线状壁的钙化,2例出现小壁结节,2例壁厚度大于3mm,6例瘤体直径大于15mm,5例出现环形壁强化及2例壁结节强化。结论:阑尾黏液性囊腺瘤CT表现为阑尾囊状扩张,密度不均,曲线状钙化壁,小壁结节,增强后瘤体边缘及壁结节强化。     

肝胆管囊腺瘤及囊腺癌的CT诊断

目的 探讨肝内胆管囊腺瘤及囊腺癌的CT表现及其病理学改变，评价CT对其诊断价值。方法 搜集6例经手术病理证实的肝胆管囊腺瘤及囊腺癌的病例，其中3例作常规CT平扫及增强扫描，3例作螺旋CT平扫及肝动脉门静脉双期增强扫描。回顾性分析6例肝内胆管囊腺瘤及胆管囊腺癌的CT表现，并与病理组织检查结果对照。结果 1例胆管囊腺瘤，呈多囊性病灶，囊壁光整，厚薄一致，部分分隔有较均匀的增厚。1例胆管囊腺瘤恶变，为单囊性病灶；4例胆管囊腺癌中3例为单囊性病灶，1例为多囊性病变。CT均见囊内主要为水样密度，5例恶性者中4例可见壁结节和(或)乳头状突起，另外1例有囊壁局部增厚；3例有厚薄不均的分隔，2例有囊壁钙化，1例有囊内出血，呈液液平征。常规增强扫描囊壁和分隔有强化。螺旋CT双期增强扫描动脉期囊壁及壁上结节明显强化，门脉期强化减退。结论 CT可显示肝内胆管囊腺瘤和囊腺癌的一些特征性表现，却难于鉴别良性胆管细胞囊腺瘤与恶性胆管细胞囊腺癌。如见病灶有间隔增厚、壁上结节或乳头状突起、囊内出血以及伴粗大钙化者多考虑为恶性的胆管细胞囊腺癌，肝内胆管囊腺瘤与囊腺癌鉴别主要依靠病理。     

阑尾黏液性囊腺癌的CT诊断

目的：探讨阑尾黏液性囊腺癌的 CT 表现特征。方法回顾性分析5例经手术及病理证实的阑尾黏液性囊腺癌的 CT资料,并复习相关文献。结果5例均表现为右下腹囊性肿块,4例呈不规则分叶状,1例管状。最大横径约27~146 mm,局部侵犯邻近肠管而边界欠清晰。囊壁厚薄不均匀,内壁欠规则并见小结节或乳头状突起;3例囊内见纤维分隔。囊内可见较多黏液,密度欠均匀,平均 CT 值约19.3~34.6 HU。增强显示囊壁及分隔较明显强化4例,中等强化1例。3例肿瘤边缘脂肪间隙较清晰,2例合并急性炎症导致邻近脂肪间隙较模糊。3例囊壁见细微点状钙化,3例邻近淋巴结肿大。结论CT 可以显示阑尾黏液性腺癌的一些病理特征,对其诊断及鉴别有较大价值。     

阑尾粘液性囊腺瘤的CT表现

目的 探讨阑尾粘液性囊腺瘤的CT特征及诊断价值,提高对其诊断的准确率.方法 回顾性分析11例经手术病理证实的阑尾粘液性囊腺瘤的临床资料及CT表现.结果 病灶位于右下腹近回盲部或右侧盆腔内,呈大小不等囊性肿块,8例呈类圆形、长管状,2例呈“逗号”征,1例呈分叶状.囊壁均匀或厚薄不均,4例囊壁有钙化.病灶均未见分隔,内容物CT值10～30HU.7例增强扫描中5例囊壁有强化,2例强化不明显,囊内容物无强化.10例病灶周围结构清晰,其中1例合并肠套叠突入盲肠内,1例与盲肠分界不清,周围并见淋巴结.结论 右下腹与盲肠相连类圆形、长管状或“逗号”样单房或多房囊性肿块,囊壁厚薄均匀或不均,肿瘤周围系膜正常,术前可提示阑尾粘液性囊腺瘤诊断.     

Choriocarcinoma of the ovary associated with mucinous cystadenoma

We report choriocarcinoma of the ovary associated with mucinous cystadenoma in a 54-year-old postmenopausal woman, the first reported case of this condition. Doppler ultrasonography, computed tomography, and magnetic resonance imaging showed hypervascularity of the tumor that corresponded to the area of choriocarcinoma within the multilocular cyst. The patient exhibited multiple pulmonary metastases and died of intracerebral hemorrhage.     

多层螺旋CT对胰腺囊腺瘤与囊腺癌的诊断价值

目的：探讨胰腺囊腺瘤和囊腺癌的多层螺旋CT表现及其诊断价值。方法：回顾性分析21例经手术病理证实的胰腺囊腺瘤和囊腺癌的多层螺旋CT表现。所有患者均行CT平扫及增强扫描,并采用多平面重组（MPR）和最大密度投影（MIP）等方法对图像进行后处理。结果：21例中胰腺浆液性囊腺瘤7例,其特征性的CT表现有蜂窝样囊性病灶（6例）且单个小囊最大直径≤2cm、分叶状（4例）、囊壁及囊内间隔增强后呈轻度强化（7例）、囊壁光整（7例）。黏液性囊腺瘤4例,主要CT表现为多房囊性病灶（4／4）、绝大多数小囊的最大直径〉2cm、囊壁较厚且厚薄不均（4例）、2例可见壁结节,增强扫描示囊壁、分隔及壁结节有轻度一中度强化。胰腺囊腺癌10例,CT平扫示肿瘤呈囊状低密度影,有壁结节及分隔;增强扫描示囊壁、壁结节及分隔呈中度一明显强化。结论：胰腺黏液性和浆液性囊腺瘤及囊腺癌的MSCT表现有一定特征性,MSCT对本病的诊断及鉴别诊断具有重要的临床价值。     

Primary mucinous cystadenocarcinoma of the appendix: CT findings.

OBJECTIVE: The preoperative diagnosis of a primary appendiceal tumor can be difficult because of its rarity and the paucity of material in the radiology literature. The purpose of this study was to describe CT findings in six patients with primary mucinous cystadenocarcinoma of the appendix. CONCLUSION: When CT reveals a cystic mass with enhancing wall nodularity in the expected area of the appendix, especially in older patients, the possibility of primary mucinous cystadenocarcinoma should be considered.     

阑尾黏液性囊腺瘤CT表现及文献复习

阑尾黏液性囊腺瘤临床少见,据文献报道其发生率占阑尾切除标本的0.43％[1-2].本病临床上无特异性症状,或主要表现为慢性非转移性右下腹疼痛以及右下腹包块,术前诊断困难,易误诊为阑尾炎、阑尾周围脓肿、回盲部肿瘤、卵巢囊肿等疾病.随着多层螺旋CT的广泛应用及普及,薄层扫描及多平面重组(multiplanar reconstruction,MPR)等重建技术能从不同角度整体观察阑尾及其周围情况,做到观察的连续性和完整性,大大提高阑尾疾病术前诊断准确率[3].现对本院经病理诊断的5例阑尾黏液性囊腺瘤进行回顾性分析,并对国内外相关文献进行复习,旨在提高对该病CT表现的认识及诊断能力.     

Assessment of MRI and MRCP in diagnosis of biliary cystadenoma and cystadenocarcinoma

Magnetic resonance imaging (MRI) and magnetic resonance cholangio-pancreatography (MRCP) features were analyzed in the diagnosis of seven surgically resected hepatobiliary cystic tumors with reference to histopathological data. Homogeneity, size, location, signal intensity, presence or absence of septa and/or nodules and MRCP features of the lesions were studied. Histological evidence demonstrated six biliary cystadenoma (BCA) including four pseudo-ovarian stroma (POS) and one biliary cystadenocarcinoma (BCAC). Cystic lesions (3–15 cm in diameter) were homogeneous in the six BCA, heterogeneous in the one BCAC, and were located in the left and right liver, respectively. On T2-weighted images all lesions were hyperintense. On T1-weighted images hypointensity was found in three BCA (all serous fluid, including one POS), isointensity was found in the three others (two mucinous and one hemorrhagic fluid, including three POS) and in the one BCAC (containing mucinous fluid). Septas were present in all cases and nodules only in the one BCAC. On MRCP a hyperintense cystic lesion was found in all cases and a bile ducts dilatation in two BCA and the one BCAC. Gadolinium-enhanced MRI in combination with MRCP is a valuable tool for the diagnosis of BCA or BCAC. However, no specific information is gained for POS detection.