Mucocele of the appendix: CT findings <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

李静  林蒙  赵燕风  蒋力明  周纯武

中国医学科学院中国协和医科大学肿瘤医院影像诊断科，北京 100021

Jing Li,  Meng Lin,  Yanfeng Zhao,  Liming Jiang,  Chunwu Zhou

(Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China )

Abstract

Objective：To investigate the CT features of mucocele of the appendix, and to improve the diagnostic ability of the disease.

Methods：All 7 patients with mucocele of the appendix were confirmed by pathology and surgery. CT findings were analyzed retrospectively.

Results：CT demonstrated a mass of low attenuation in the right lower quadrant in all 7 cases. The mucocele was a homogeneous cystic mass in 4 cases, cystic mass with internal septations in 2 cases, and cystic mass with peripheral soft tissue in 1 case. The masses were either spherical (n=2) or elongated (n=5) in shape. Two masses had mural calcification, and 4 had mural enhancement after contrast enhancement.

Conclusion：CT scan is a useful method in diagnosing mucocele of the appendix. The typical CT findings of appendiceal mucocele is a well-encapsulated, spherical or elongated cystic mass in right lower quadrant, sometimes with mural calcification.

Key words： Mucocele;  Appendix;  Tomography, X-ray computed

阑尾粘液囊肿是由于阑尾腔近端阻塞导致远端粘液聚积、囊状扩张的结果，临床较少见，仅占阑尾手术切除标本的0.2％-0.3％^[1]，术前作出正确诊断有助于防止术中破裂引起腹膜假粘液瘤。临床检查和传统X线检查很难作出正确诊断；现代影像技术，尤其是CT和超声对阑尾粘液囊肿的术前诊断十分有价值。本文搜集了我院10年来经手术病理证实的有CT资料的阑尾粘液囊肿7例，探讨其CT特点，以提高术前诊断的准确率。

材料与方法

回顾性分析7例阑尾粘液囊肿的CT表现，其中男4例，女3例，年龄39岁－72岁，中位年龄52岁。均经手术病理证实，病理诊断为阑尾粘液囊肿6例，粘液性囊腺瘤1例（该例同时合并升结肠、直肠中分化腺癌）；7例中2例合并腹膜假粘液瘤。临床表现右下腹肿物3例，右下腹疼痛、不适3例，无阑尾相关症状因直肠肿物行CT检查偶然发现右下腹病变1例。临床体检6例触及右下腹肿物，4例无压痛，2例有压痛；另1例体检未触及肿物。7例中5例同时行超声扫描，3例行结肠双对比造影，2例行纤维结肠镜检查。

CT扫描方法：采用GE9800Hilight CT扫描机或PQ6000螺旋CT扫描机或GE LightSpeed Ultra 8层螺旋CT扫描机。扫描范围从膈顶至耻骨联合，螺旋CT扫描层厚5mm，层距5mm；传统CT扫描层厚10mm，层距10mm。6例行增强扫描，采用高压注射器经肘前静脉注射60％非离子型碘对比剂100ml，注射速率2.0ml/s-3.0ml/s，扫描延迟时间50s-65s。