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目的探讨直肠黏液腺癌(MA)的MRI特征。方法回顾性分析经病理证实的15例直肠MA的临床资料和MRI表现,15例均行MRI平扫,其中9例行动态增强扫描,分析其影像特征。结果 15例直肠MA表现为肠壁增厚型12例(病变长度平均10.2 cm,厚度平均2.5 cm),其中10例在DWI及ADC图上具有较T_2WI分辨更清晰的同心圆或夹心饼样分层信号;肿块型3例(病变厚度平均3.4 cm)。肿瘤T_1WI呈等或稍低信号;T_2WI以高信号为主,其内可见斑片状等信号或低信号间隔;DWI呈等或高信号,或不均匀稍高和明显高亮信号;ADC图以高信号为主,高信号区平均ADC值2.09×10~(-3)mm~2/s;增强扫描肿瘤黏液部分呈不均匀延迟强化,黏膜下层强化弱呈中间空表现,实性腺癌部分呈较均匀持续明显强化。结论直肠黏液腺癌的节段长、肠壁厚及中间空MRI特征对其诊断及鉴别诊断有重要价值。
Objective To investigate the MRI features of rectal mucinous adenocarcinoma (MA). Methods The clinical data and MRI manifestations of 15 cases of rectum MA confirmed by pathology were analyzed retrospectively. Fifteen patients underwent MRI plain scan. Among them, 9 patients underwent dynamic contrast-enhanced scanning and their imaging features were analyzed. Results In the rectum of 15 cases, there were 12 cases of intestinal wall thickening type (average length of lesion was 10.2 cm and average thickness of 2.5 cm). Among them, 10 cases had concentric circles or sandwich cakes with clearer resolution than T 2 WI in DWI and ADC images Layer signal; mass type in 3 cases (average thickness of 3.4 cm). Tumor T_1WI was equal or slightly lower signal; T_2WI is mainly high signal, which can be seen within the patchy signal or low signal interval; DWI was equal or high signal, or slightly higher and significantly higher bright signal; ADC map to High signal, the average ADC value of high signal area was 2.09 × 10 ~ (-3) mm ~ 2 / s. The mucinous part of the enhanced scan showed uneven delay enhancement, the submucosal weakness showed a weakening in the middle, the solid part of the adenocarcinoma More sustained and significantly enhanced. Conclusion Rectal mucinous adenocarcinoma of the segment length, intestinal wall thickness and the characteristics of the middle of the MRI diagnosis and differential diagnosis of great value.