放射学实践
放射學實踐
방사학실천
RADIOLOGIC PRACTICE
2014年
6期
668-672
,共5页
胃肠道%消化系统肿瘤%体层摄影术,X线计算机
胃腸道%消化繫統腫瘤%體層攝影術,X線計算機
위장도%소화계통종류%체층섭영술,X선계산궤
Gastrointestinal tract%Digestive system neoplasms%Tomography,X-ray computed
目的：探讨胃肠道外间质瘤（EGIST）的CT特征及其临床价值，提高对该肿瘤的认识水平。方法：回顾性分析经手术和病理证实的16例EGIST患者CT表现，所有病例均行平扫和增强扫描并行 MPR分析，另有3例行血管 MIP及VR成像。结果：多发肿瘤1例位于大网膜、肠系膜、腹膜；单发15例，位于大网膜6例，肠系膜5例，腹膜后4例。肿瘤最大直径3．5～23．5cm。2例呈圆形，14例呈不规则、分叶状。8例肿瘤与邻近组织脏器粘连分界不清。平扫2例密度均匀，其中1例完全囊变，增强扫描囊壁轻微强化，1例均匀强化；平扫14例密度不均，均可见程度不同的坏死、囊变，其中1例有钙化，增强扫描实质部分轻至中度强化，囊变坏死部分无强化，7例肿瘤实质内可见条状、簇状血管影，血管 MIP 及VR有助于明确肿瘤供血来源和发病部位。病理结果：良性1例，交界性3例，恶性12例。结论：EGIST 影像学表现有一定特征，病理上以交界性和恶性居多，螺旋CT及其后处理重建对该肿瘤的诊断和鉴别诊断以及术前评估具有重要参考价值。
目的：探討胃腸道外間質瘤（EGIST）的CT特徵及其臨床價值，提高對該腫瘤的認識水平。方法：迴顧性分析經手術和病理證實的16例EGIST患者CT錶現，所有病例均行平掃和增彊掃描併行 MPR分析，另有3例行血管 MIP及VR成像。結果：多髮腫瘤1例位于大網膜、腸繫膜、腹膜；單髮15例，位于大網膜6例，腸繫膜5例，腹膜後4例。腫瘤最大直徑3．5～23．5cm。2例呈圓形，14例呈不規則、分葉狀。8例腫瘤與鄰近組織髒器粘連分界不清。平掃2例密度均勻，其中1例完全囊變，增彊掃描囊壁輕微彊化，1例均勻彊化；平掃14例密度不均，均可見程度不同的壞死、囊變，其中1例有鈣化，增彊掃描實質部分輕至中度彊化，囊變壞死部分無彊化，7例腫瘤實質內可見條狀、簇狀血管影，血管 MIP 及VR有助于明確腫瘤供血來源和髮病部位。病理結果：良性1例，交界性3例，噁性12例。結論：EGIST 影像學錶現有一定特徵，病理上以交界性和噁性居多，螺鏇CT及其後處理重建對該腫瘤的診斷和鑒彆診斷以及術前評估具有重要參攷價值。
목적：탐토위장도외간질류（EGIST）적CT특정급기림상개치，제고대해종류적인식수평。방법：회고성분석경수술화병리증실적16례EGIST환자CT표현，소유병례균행평소화증강소묘병행 MPR분석，령유3례행혈관 MIP급VR성상。결과：다발종류1례위우대망막、장계막、복막；단발15례，위우대망막6례，장계막5례，복막후4례。종류최대직경3．5～23．5cm。2례정원형，14례정불규칙、분협상。8례종류여린근조직장기점련분계불청。평소2례밀도균균，기중1례완전낭변，증강소묘낭벽경미강화，1례균균강화；평소14례밀도불균，균가견정도불동적배사、낭변，기중1례유개화，증강소묘실질부분경지중도강화，낭변배사부분무강화，7례종류실질내가견조상、족상혈관영，혈관 MIP 급VR유조우명학종류공혈래원화발병부위。병리결과：량성1례，교계성3례，악성12례。결론：EGIST 영상학표현유일정특정，병리상이교계성화악성거다，라선CT급기후처리중건대해종류적진단화감별진단이급술전평고구유중요삼고개치。
Objective:The purpose of our study was to discuss the clinical value of the CT features of extragastroint-estinal stromal tumor (EGIST)in order to better understand it.Methods:CT findings of 1 6 patients with EGIST confirmed by operation and pathology were retrospectively reviewed.All patients were performed both plain and enhanced scan with MPR.Three of them also perform MIP and VR.Results:Multi-focal lesions was found in one case,located at the greater o-mentum,mesentery and peritoneum.Single lesion was observed in 15 cases:greater omentum 6,mesentery 5 and retroperito-neum 4.The larger diameter was 3.5~23.5cm.Two tumors presented round shape and other 14 had irregular and lobulated margins.Eight lesions showed unclear boundaries with adjacent tissues and organs due to adhesions.As for plain scan there were only 2 cases with homogeneous density,including one was completely cystic with slight enhancement in the wall,and one was evenly enhanced.Other 14 cases on plain scan with uneven density presented different degree of necrosis and cysts, including one with calcification.All 14 cases showed partially slight to moderate enhancement.Strip-like and clustered ves-sels were seen in 7 cases,in which MIP and VR help clarify the tumor blood supply and origin.Pathological results:benign stromal tumor in one case,borderline 3,and malignant 12.Conclusion:EGIST has some imaging characteristics and the ma-jority is borderline to malignant in pathology.Spiral CT and post-processing reconstruction are of remarkable reference value in the diagnosis,differentiation and preoperative evaluation.
