摘要
目的:回顾性分析胃底间质瘤的增强MSCT影像特征,探索其与病理分级的关系。方法:回顾性分析经手术病理和免疫组化证实的49例胃底间质瘤的增强MSCT征象。统计病变数目、大小、生长方式、有无溃疡、有无坏死、有无消化道出血、外生型是否侵及胃脾韧带、动脉期和静脉期的CT值、强化程度。根据病理危险度分级,对比分析上述MSCT征象;并与文献中胃间质瘤和小肠间质瘤的CT征象对比分析。结果:最大径>5cm与≤5cm的胃底间质瘤的危险度分布的差异有统计学意义(P<0.001,r=0.709)。腔内生长、腔内外生长、腔外生长的胃底间质瘤危险度分布的差异有统计学意义(P=0.021,r=0.317)。有、无溃疡的胃底间质瘤危险度分布的差异有统计学意义(P=0.002,r=0.459)。有、无坏死的胃底间质瘤危险度分布的差异有统计学意义(P<0.001,r=0.561)。与小肠间质瘤比较,危险度为高危或非高危的差异有统计学意义(P=0.047,RR=2.096);生长方式、有无溃疡的差异有统计学意义(P<0.001)。与胃间质瘤相比,生长方式、有无溃疡、有无坏死的差异有统计学意义,P=0.001,P<0.001、P<0.001)。结论:胃底间质瘤MSCT影像表现具有一定特征,高危险度的病灶较大(>5cm)、腔外生长为主,溃疡、坏死发生率较高。胃底间质瘤危险度为高危的概率高于小肠间质瘤。与胃间质瘤不同,胃底间质瘤以腔内生长多见,腔内生长者以中危险度及以下为主,胃底间质瘤更容易出现溃疡、坏死。
Objective:The enhanced MSCT imaging features of gastric fundus stromal tumors(GIST)were analyzed retrospectively to explore its relationship with pathological risk grading.Methods:Enhanced MSCT imaging features of 49 cases of gastric fundus stromal tumors were retrospectively analyzed,including the number of lesions,size,growth pattern,presence of ulceration,presence of necrosis,presence of gastrointestinal bleeding,whether the exophytic type invaded the gastrosplenic ligament,CT values in arterial and venous phase,and the degree of enhancement.The above MSCT parameters were compared and analyzed according to the pathological risk grading and compared with the CT signs of gastric GIST and intestinal GIST in the literature.Results:The differences in the risk distribution of gastric fundus GIST between the largest diameter>5cm and≤5cm(P<0.05,r=0.709),three growth patterns(P<0.05,r=0.317),with or without ulceration(P=0.002,r=0.459),and with or without necrosis(P=0.002,r=0.459)were all statistically significant.Compared with intestinal GIST,the difference in risk of high-risk or non-high-risk was statistically significant(P<0.05,RR=2.096).The difference in growth patterns,with or without ulceration were statistically significant(P<0.001).Compared with gastric GIST,the differences in growth patterns(P=0.001),ulceration(P<0.001),and necrosis(P<0.001)were statistically significant.Conclusion:MSCT images of gastric fundus GIST have certain characteristics.The high-risk lesions are larger(>5cm),mainly extraluminal growth,and have a higher incidence of ulcers and necrosis.The risk of gastric fundus GIST is higher than that of small intestine GIST.Unlike gastric GIST,gastric fundus GIST is more common in intraluminal growth,and intraluminal growth is mainly at medium risk and below.Gastric fundus GIST is more prone to ulcers and necrosis.
作者
陈媛慧
张进华
胡道予
陈晓
CHEN Yuan-hui;ZHANG Jin-hua;HU Dao-yu(Department of Medical Imaging,the Third Affiliated Hospital of Nanchang University,Nanchang 330008,China)
出处
《放射学实践》
北大核心
2020年第11期1458-1463,共6页
Radiologic Practice
关键词
胃肿瘤
胃底间质瘤
计算机体层摄影
危险度分级
Gastric neoplasms
Gastric fundus stromal tumor
Computer tomography
Risk stratification
