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成人直肠后肿瘤:磁共振成像表现。

Retrorectal tumors in adults: magnetic resonance imaging findings.

机构信息

Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, No.155 Hanzhong Road, Nanjing 210029, China.

出版信息

World J Gastroenterol. 2010 Dec 14;16(46):5822-9. doi: 10.3748/wjg.v16.i46.5822.

Abstract

AIM

To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.

METHODS

MRI features of 21 patients with preoperative suspicion of retrorectal tumors were analyzed based on the histopathological and clinical data.

RESULTS

Fourteen benign cystic lesions appeared hypointense on T1-weighted images, and hyperintense on T2-weighted images with regular peripheral rim. Epidermoid or dermoid cysts were unilocular, and tailgut cysts were multilocular. Presence of intracystic intermediate signal intensity was observed in one case of tailgut cyst with a component of adenocarcinoma. Six solid tumors were malignant lesions and showed heterogeneous intensity on MRI. Mucinous adenocarcinomas showed high signal intensity on T2-weighted and mesh-like enhancing areas on fat-suppressed T2-weighted images. There was a fistula between the mass and anus with an internal opening in mucinous adenocarcinomas arising from anal fistula. Gastrointestinal stromal tumors displayed low signal intensity on T1-weighted images, and intermediate to high signal intensity on T2-weighted images. Central necrosis could be seen as a high signal on T2-weighted images.

CONCLUSION

MRI is a helpful technique to define the extent of the retrorectal tumor and its relationship to the surrounding structures, and also to demonstrate possible complications so as to choose the best surgical approach.

摘要

目的

回顾性分析成人直肠后肿瘤的磁共振成像(MRI)特征,并与组织病理学发现进行比较。

方法

基于组织病理学和临床资料,分析了 21 例术前怀疑直肠后肿瘤患者的 MRI 特征。

结果

14 个良性囊性病变在 T1 加权图像上呈低信号,在 T2 加权图像上呈高信号,边缘规则。表皮样囊肿或皮样囊肿为单房性,尾肠囊肿为多房性。1 例尾肠囊肿伴有腺癌成分,可见囊内中等信号强度。6 个实性肿瘤为恶性病变,在 MRI 上呈不均匀信号强度。黏液性腺癌在 T2 加权图像上呈高信号,在脂肪抑制 T2 加权图像上呈网格状增强区。来源于肛瘘的黏液性腺癌与肛门之间有瘘管,内口可见。胃肠道间质瘤在 T1 加权图像上呈低信号,在 T2 加权图像上呈中至高信号强度。T2 加权图像上可见中央坏死呈高信号。

结论

MRI 是一种有助于确定直肠后肿瘤范围及其与周围结构关系的技术,还可以显示可能的并发症,以便选择最佳的手术方法。

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