CAJ | 학술논문

目的：分析胰头区域十二指肠间质瘤（DST ）的 CT、MRI表现，旨在提高对该疾患的认识。方法回顾性分析11例经免疫组化证实的十二指肠间质瘤的C T 和M RI表现，11例患者均行C T 检查8例，3例同时行C T和 M RI检查，重点观察肿瘤部位、形态、大小、边界、密度/信号、增强程度及胰胆管扩张等，统计分析C T、M RI表现，并和病理结果作对照分析。结果11例患者中，手术病理结果为良性3例，交界性2例，恶性6例。其中9例位于十二指肠降部（81.8％，9/11），2例位于水平部（18．2％，2/11）；呈圆形及椭圆形5例（45．5％，5/11），呈不规则分叶状或浅分叶6例（54．5％，6/11）；肿块向腔内生长3例（27．3％，3/11），向腔内外生长2例（18．2％，2/11），向腔外生长6例（54．5％，6/11）。C T和M R平扫肿块呈实性等密度/等信号者3例（27．3％，3/11），呈囊实性混杂密度/信号者8例（72．7％，8/11）；增强后3例中度至明显均匀强化（27．3％，3/11），8例呈中度至明显不均匀强化（72．7％，8/11）。病灶内见钙化、气体影、胆管扩张各见1例（9．1％，1/11）。结论 DST 多为腔外生长，中心偏向十二指肠，肿块富血供，呈明显强化；肿块内气体、钙化可能为少见特征表现；如肿块分叶状、局部坏死囊变、强化不均，则多提示为恶性或潜在恶性。
목적：분석이두구역십이지장간질류（DST ）적 CT、MRI표현，지재제고대해질환적인식。방법회고성분석11례경면역조화증실적십이지장간질류적C T 화M RI표현，11례환자균행C T 검사8례，3례동시행C T화 M RI검사，중점관찰종류부위、형태、대소、변계、밀도/신호、증강정도급이담관확장등，통계분석C T、M RI표현，병화병리결과작대조분석。결과11례환자중，수술병리결과위량성3례，교계성2례，악성6례。기중9례위우십이지장강부（81.8％，9/11），2례위우수평부（18．2％，2/11）；정원형급타원형5례（45．5％，5/11），정불규칙분협상혹천분협6례（54．5％，6/11）；종괴향강내생장3례（27．3％，3/11），향강내외생장2례（18．2％，2/11），향강외생장6례（54．5％，6/11）。C T화M R평소종괴정실성등밀도/등신호자3례（27．3％，3/11），정낭실성혼잡밀도/신호자8례（72．7％，8/11）；증강후3례중도지명현균균강화（27．3％，3/11），8례정중도지명현불균균강화（72．7％，8/11）。병조내견개화、기체영、담관확장각견1례（9．1％，1/11）。결론 DST 다위강외생장，중심편향십이지장，종괴부혈공，정명현강화；종괴내기체、개화가능위소견특정표현；여종괴분협상、국부배사낭변、강화불균，칙다제시위악성혹잠재악성。
Objective The purpose of this investigation is to study the CT and MRI imaging characteristics of duodenum stromal tumors ,in order to further improve the understanding the disease .Methods The CT imaging of 11 cases ,in which 3 with MR Imaging of duodenum stromal tumors confirmed operatively and pathologically ,were reviewed and ana-lyzed .The statistical analysis focused on the lesions’location ,shape ,size ,border of tumors ,CT density/MRI signal in-tensity ,enhancement degree ,and pancreas and bile duct expansion etc .Then ,combination with surgical pathology re-sults ,the relationship between imaging characteristics and pathological subtypes was analyzed .Results 6 of the 11 tumors were malignant ,2 of them were potentially malignant ,3 of them were benign ;9 tumors were located in descending part ,2 in horizontal part ;6 tumors had a lobulated contour ,5 tumors were round or oval in shape ;6 grew outward cavi-ty ,2 in-out cavity and 3 cavity growth .On CT/MR examinations ,3 tumors appeared as homogenous density/signal and 8 tumors as heterogenous density/signal .After iv administration of contrast materials ,3 tumors were demonstrated homoge-neous enhancement ,while ,the remaining 8 tumors showed heterogeneous enhancement .Calcification ,gaseous density , bile duct expansion were shown in 1 case respectively .Conclusion Duodenum stromal tumors grew outward cavity ,were close to duodenum ,appeared as heterogenous and showed a circumjacent enhancement pattern on the arterial phase .Calci-fication and gaseous density may be rare and characteristic features .If the tumors had a lobulated contour ,appeared as heterogenous ,showed a circumjacent enhancement pattern ,it implied malignant neoplasm and potentially malignant neo-plasm .