The diagnostic value of 64-slice Spiral CT in uncommon disease of appendix

Objective To evaluate the diagnostic value of 64-slice Spiral CT in uncommon disease of appendix.Methods Imaging features of 64-slice Spiral CT for 23 patients with pathologically and surgically proved uncommon disease of appendix were retrospectively analyzed.Results Uncommon disease of appendix including 7mucinous cysts,2fibrotic appendixes,9adenocarcinomaes,3lymphomaes,1carcinoid and 1clear cell sarcoma were involved in our study.All lesions were well visualized on CT transverse plane and MPR,MIP reconstructed images.Mucinous cysts manifested as a round cystic mass with no enhancement,usually with a calcified wall.The density of the fluid varied with the content.The inflamed wall thickened and mild enhanced.The fibrotic appendix represented as a thickened tubular structure,which mimics a mass with radiate stripe on transverse images.Appendicolith was shown in one case.The mucinous carcinoma demonstrated as a cystic-solid mass with heterogeneous attenuation or marked asymmetric appendical wall thickening,mild local fatty infiltration,with moderate enhancement.Two cases accompanied by liver metastsis and one case by retroperitoneal lymphadenopathy.One case of lymphoma appeared as multiple nodules within the thickened wall of appendix with mild enhancement.One case of carcinoid showed a cystic-solid mass with moderate enhancement.One case of clear cell sarcoma showed a soft tissue mass with necrosis in the center,the solid component enhanced markedly.Conclusion The image features of uncommon diseases of appendix and its relationships with surrounding structures can be sufficiently demonstrated using 64-slice Spiral CT enhancing and MPR,MIP techniques,which was valuable for qualitative diagnosis and clinical management.