CAJ | 학술논문

目的探讨小肠间质瘤的CT表现特点及不同危险性CT征象.方法回顾性观察25例经手术病理证实的小肠间质瘤CT资料,并与手术及病理所见相对照;分析依据病理组织学分级的不同危险性组别的CT征象,并对其差别进行x2检验.结果肿瘤起源于空肠9例,回肠13例,十二指肠3例.黏膜下型2例,肌壁间型13例,浆膜下型10例.病理分型:高危12例,中危7例,低危5例,极低危1例.典型CT表现为形态不规则或类圆形软组织肿块,多外向性生长,边界清楚,密度不均匀,与病理对照为坏死囊变、黏液变性及空洞或窦道形成.肠系膜脂肪受侵呈点索状高密度.增强扫描多明显强化,动静脉期强化峰值变化不大.小肠间质瘤以5 cm为界的大小、形态是否规则、密度是否均匀、强化动脉期有无血管样影,在不同危险性组别(极低危及低危险组与中高危险组)中差异有统计学意义(P＜0.05);强化程度差异无统计学意义(P＞0.05).结论小肠间质瘤CT表现有一定的特点;不同危险性肿瘤的某些CT征象有差异性,中高危险性多表现为直径大于5 cm、密度不均匀、形态不规则、见血管样强化.
목적 탐토소장간질류적CT표현특점급불동위험성CT정상.방법 회고성관찰25례경수술병리증실적소장간질류CT자료,병여수술급병리소견상대조;분석의거병리조직학분급적불동위험성조별적CT정상,병대기차별진행x2검험.결과 종류기원우공장9례,회장13례,십이지장3례.점막하형2례,기벽간형13례,장막하형10례.병리분형:고위12례,중위7례,저위5례,겁저위1례.전형CT표현위형태불규칙혹류원형연조직종괴,다외향성생장,변계청초,밀도불균균,여병리대조위배사낭변、점액변성급공동혹두도형성.장계막지방수침정점색상고밀도.증강소묘다명현강화,동정맥기강화봉치변화불대.소장간질류이5 cm위계적대소、형태시부규칙、밀도시부균균、강화동맥기유무혈관양영,재불동위험성조별(겁저위급저위험조여중고위험조)중차이유통계학의의(P＜0.05);강화정도차이무통계학의의(P＞0.05).결론 소장간질류CT표현유일정적특점;불동위험성종류적모사CT정상유차이성,중고위험성다표현위직경대우5 cm、밀도불균균、형태불규칙、견혈관양강화.
Objective To investigate the CT features and different risk CT findings of intestinal stromal tumor. Methods The CT imaging data of 25 cases of intestinal stromal tumor confirmed by pathology and compared with operative and pathologic findings were retrospectively studied. Analyzing the CT features based on Histopathologieal classification of the different risk groups and using chi-square test to compare the differences. Results There were 9 cases which tumors originated from the jejunum, and 13 cases from ileum, only 3 cases from duodenum. Among them, 2 cases were submucosal type, 13 cases were intramural type, and 10 cases were subserous type. The pathologic patterns of different risk which included high-risk, intermediated-risk, low-risk, and very low-risk were 12 cases, 7 cases, 5 cases and 1 cases respectively. A typical CT manifestations of intestinal stromal tumors were a outward growth of irregular or round soft tissue mass originated in small intestine which had clear boundary and the non-homogeneous density, which corresponding to necrosis, cystic change, mucoid degeneration and sinus or cavity. Mesenteric fat invaded by tumor showed high-density lines or points shape. The Enhancement of lesion was obvious and not homogeneous which showed little change in peak of enhancement between arterial phase and venous phase. Intestinal stromal tumors took 5 cm as the boundary which including different size, shape, density, and appearance vessel-like artery shadow at arterial phase between different risk groups(low, very low-risk group and intermediated, high-risk group) were statistically different (P ＜0.05), while enhanced degree without significant difference (P ＞ 0.05). Conclusion CT findings of small intestine stromal tumor have characteristics and CT features have significant difference between different risk groups. These features of more than 5 cm in diameter, non-homogeneous density, irregular shape and chaos appearance like vascular enhancement are showed in intermediated-high-risk group.