目的评价多层螺旋CT用于鉴别 粘液性与非粘液性结直肠癌的价值。方法 收集经病理学确诊为结直肠粘液性癌患 者69例和非粘液性癌患者85例的MSCT影像 资料，对其MSCT特征进行回顾性分析，并 比较两种肿瘤肠壁受累方式、增强形式、 继发性肠梗阻、瘤内钙化、肠周脂肪浸 润、以及对邻近器官侵犯等特征的差异。 结果 粘液性癌肠壁增厚(2.52±1.14cm) 程度较非粘液性癌(1.91±0.96cm)更 重(P=0.003)，粘液性癌有84.1%表现 为不均匀强化，较非粘液性癌(51.8%) 更常见(P=0.001)，且粘液性癌的低密 度范围更大(P=0.001)，偏心程度更高 （P=0.027)。与非粘液性癌比较，粘液性 癌的实性成分强化程度更低(P=0.001)， 瘤内钙化更常见(P=0.001)。在两种肿瘤 的鉴别诊断中，不均匀强化的敏感度最高 (84.1%)，特异性中等(58.4%)，当4种以 上MSCT特征存在显著性差异时，则肿瘤很 可能是粘液性癌，其特异性为90.5%。结 论 MSCT可作为鉴别粘液性与非粘液性结 直肠癌的有效检查方法。

Objective To evaluate the value of multislice spiral CT (MSCT) in the differentiation between mucinous and non-mucinous colorectal carcinoma. Methods MSCT imaging data of 69 patients with mucinous colorectal carcinoma and 85 patients with nonmucinous colorectal carcinoma confirmed by pathology were analyzed retrospectively. MSCT findings were compared between the two groups with regard to the bowel involvement patterns, patterns of contrast enhancement, secondary bowel obstruction, intratumoral calcification, pericolic fat infiltration, and tumor extension to adjacent organs. Results Compared with nonmucinous carcinoma, mucinous carcinoma showed more severe bowel-wall thickening (2.52±1.14cm vs 1.91±0.96cm) (P=0.003) .Heterogeneous enhancement was more common in mucinous than nonmucinous carcinoma (84.1% vs 51.8%) (P=0.001). Mucinous carcinoma showed more areas with low density (P=0.001) and more eccentric degree(P=0.027),and its solid portion showed less enhancement than that of nonmucinous carcinoma (P=0.001), and the presence of intratumoral calcification were more frequent in mucinous carcinoma (P=0.001). Heterogeneous enhancement showed the highest sensitivity (84.1%) but moderate specificity (58.4%) in diagnosing mucinous carcinoma. Tumors with four or more CT findings with a statistically significant difference were mostly mucinous carcinoma, and the specificity was 90.5%. Conclusion MSCT can be used as an effective method for the differential diagnosis between mucinous and nonmucinous colorectal carcinoma.