摘要
目的探讨直肠间质瘤的MRI表现、表观扩散系数(ADC)及与临床危险度分级的关系。资料与方法回顾性收集2013年1月—2021年1月徐州市中心医院经病理证实且有术前MRI平扫及扩散加权成像(DWI)检查、全腹CT检查资料的直肠间质瘤患者17例,观察肿瘤的MRI表现,包括病灶部位、生长方式、信号、边界、最大径,并在ADC图上选择病灶实性成分较大的3个层面勾画感兴趣区,根据美国国立卫生研究院(NIH)2008改良版标准进行危险度分级,分为极低/低危、中/高危组。比较两组ADC值的差异,并对肿瘤的MRI特征与危险度分级进行对比分析。结果17例肿瘤均为单发且未发现腹部远处转移,均位于低位直肠,15例位于直肠-肛管角上缘;15例位于直肠前壁,2例位于侧壁;信号均匀6例,T2WI均呈稍高、T1WI稍低信号;信号不均匀11例,T2WI呈稍高/高/低信号、T1WI呈等/稍高/低信号,其中囊变坏死6例,有出血信号3例,可见液平1例,伴钙化1例;5例局部与邻近结构分界欠清/可疑欠清,12例病灶边界清晰。病灶最大径约1.7~16.0 cm。极低/低危组与中/高危组ADC值差异有统计学意义[(1.16±1.95)×10^(-3)mm^(2)/s比(0.94±1.59)×10^(-3)mm^(2)/s;t=2.227,P<0.05]。肿瘤最大径、信号是否均匀与危险度分级差异有统计学意义(P<0.05)。结论直肠间质瘤的常规MRI表现及ADC值有助于诊断及危险度大致分级,ADC值越小,病灶危险度分级越高。
Purpose To investigate MRI findings and apparent diffusion coefficient(ADC)of rectal stromal tumor and the relationship with clinical risk grade.Materials and Methods Seventeen patients with rectal stromal tumor who were pathologically confirmed and had preoperative MRI plain scan,diffusion-weighted imaging(DWI)examination and whole abdominal CT examination in Xuzhou Central Hospital from January 2013 to January 2021were retrospectively collected.The MRI characteristics of the tumor including location,growth pattern,signal uniformity,boundary and maximum diameter were evaluated,and the areas of interest were delineated by selecting three layers with large solid components on ADC map.Risk grading was performed according to the 2008 modified standard of NIH.All patients were divided into extremely low/low risk,medium/high risk groups.The differences in ADC values between the two groups were compared as well as the MRI characteristics.Results All the tumors were single,without distal abdominal metastasis.All lesions were located in the lower rectum,with 15 tumors in the upper edge of rectoanal angle,15 in the anterior wall of rectum and two in the lateral wall.Six cases with uniform signal showed slightly higher T2WI and slightly lower T1WI signal.11 patients with uneven signal showed slightly higher/higher/lower T2WI and isointense/slightly higher/lower T1WI signal,including six patients with capsular deterioration,three patients with hemorrhage signal,one patient with visible fluid level,and one patient with calcification.In five cases,the boundary between local and adjacent structures was unclear/suspected unclear,and in 12 cases,the boundary of lesions was clear.The maximum diameter of the lesion was 1.7-16.0 cm.There was significant difference in ADC values between extremely low/low risk group and medium/high risk group[(1.16±1.95)×10^(-3)mm^(2)/s vs.(0.94±1.59)×10^(-3)mm^(2)/s;t=2.227,P<0.05].There were statistically significant differences in the maximum diameter of tumor and signal uniformity between the
作者
杨宁
张佳
马喜娟
师毅冰
汪秀玲
YANG Ning;ZHANG Jia;MA Xijuan;SHI Yibing;WANG Xiuling(Department of Imaging,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2022年第5期480-483,489,共5页
Chinese Journal of Medical Imaging
关键词
胃肠道间质瘤
磁共振成像
扩散加权成像
表观扩散系数
病理学
外科
诊断
Gastrointestinal stromal tumors
Magnetic resonance imaging
Diffusion weighted imaging
Apparent diffusion coefficient
Pathology
surgical
Diagnosis
