摘要
目的:探讨胃肠道间叶源性肿瘤(GIMT)的16层螺旋CT(MSCT)和超声内镜(EUS)表现及其诊断价值。方法:回顾性分析手术病理证实的GIMT 37例,术前37例均行CT平扫,35例行双期增强扫描,17例行超声内镜检查。结果:胃肠道间质瘤(GIST)31例(食道1例,胃19例,小肠6例,直肠1例,胃肠外4例),平滑肌瘤4例(食道3例,胃1例),胃神经源性肿瘤2例。①CT表现:黏膜下富血供肿块,倾向腔外生长,可有囊变、坏死、出血、钙化,无淋巴结转移。增强后良性GIMT及交界性GIST均匀强化,边界清楚,良性GIMT肿块直径1.0～3.0cm,平均2.16cm。胃交界性GIST直径1.2～3.5cm,平均2.24cm。恶性GIMT强化不均匀,肿瘤最大径3.5～16.0cm,平均6.9cm,可有邻近脏器侵犯。定位准确率30/37(81.08%),定性准确率20/37(54.05%)。②EUS表现:内镜表现为黏膜下隆起性病变,EUS显示肿瘤起源于黏膜肌层或固有肌层的低回声改变,良性GIMT内部回声均匀,边界清楚,肿瘤最大径0.5～3.5cm,平均1.75cm。恶性GIMT回声多不均匀,可伴有液性暗区,形态不规则,可有浸润性改变,肿瘤最大径6.0～10cm,平均9.2cm。定位准确率16/17(94.12%),定性准确率15/17(88.23%)。结论:MSCT和EUS能准确显示肿瘤的部位、形态、大小,内部结构及浸润情况,有利于良恶性的判断,对临床治疗及预后有着重要的指导价值。
Objective： To investigate the manifestation of gastrointestinal mesenchymal tumors （GIMTs） in 16-row spiral CT and EUS, and the diagnostic value of MSCT and EUS in GIMTs. Methods： Thirty-seven patients with pathologically proved GIMTs were analyzed retrospectively, Plain scan in 37 cases, two-phase dynamic enhanced spiral CT in 35 cases and EUS in 17 cases were made before surgery. Results： Among those there were 31 GISTs （19 in the stomach and 1, 6, 1, 4 in the esophagus, duodenum, colon and outsides gastrointestinal tract respectively）, leiomyoma 4 cases （3 in the esophagus and 1 in the stomach）, stomach schwannoglioma 2 cases. （1）The important CT features were as follow： tumors with abundant vascularity in submucosa inclined to exophytic, showed necrosis, cystic degeneration, hemorrhage and calcifications, with no lymphnode metastasis. The benign and potential malignant GISTs displayed homogeneous enhancement with well-defined borders, The diameter of most tumor was 1.0-3.0cm （mean 2.16cm） in benign GIMTs and 1.2-3.5cm （mean 2.24cm） in potential malignant GIMTs, The malignant GIMTs exhibited inhomogeneous enhancement and invasion to adjacent organs, The diameter varied from 3.5cm to 16.0cm（mean 6.9cm） in malignant GIMTs. Accuracy of CT diagnosis for qualitative analysis was 20/37（54.05%） and for location was 30/37（81.08%） of GIMTs, （2）Endoscopic and EUS characteristics： endoscopically, GIMTs had the following appearances： submucosal protuberance. They all showed low echo images originated from the muscularis propria or muscularis mucosa on EUS. Benign tumors had homogeneous internal echoes with smooth margin, and the diameter varied from 0,5cm to 3,5cm （mean 1.75cm）. The malignant lesions showed heterogeneous internal echoes, with or without fluid low echo, irregular border, and infiltration of the mesentery. The diameter ranged from 6.0cm to lOcm（mean 9.2cm）. The accuracy of diagnosis for qualitative analysis was 15/17 （88.24%） and for location w
出处
《中国临床医学影像杂志》
CAS
北大核心
2008年第4期250-254,共5页
Journal of China Clinic Medical Imaging
