CAJ | 학술논문

目的分析胃肠道外间质瘤的CT表现,提高该瘤诊断水平.方法回顾性分析14例经手术和病理学证实的胃肠道外间质瘤CT的表现.结果14例肿瘤中发生于网膜2例,腹膜后5例,肠系膜7例,肿块多发者3例.肿块直径约为3~200 mm之间.CT平扫病灶呈小结节状、类圆形或分叶状,4例病灶与周围肠管分界清,1例平扫密度均匀CT值约为31 HU,增强动脉期明显强化,CT值约为50~60 HU,内未见坏死;10例病灶与周围肠管部分粘连,部分分界清,形态为不规则形及类圆形,肿块平扫呈不均匀低密度,实性部分低于肌肉密度,内可见斑片状、片状及大片状坏死区,实性部分CT值约为30~42 HU,增强后呈轻中度、显著不均匀性强化,CT值约为50~90 HU,病灶中央更低密度囊变坏死区未见明显强化;其中1例病灶实性部分可见少许分布的针尖样钙化点,另1例肿块边缘多发小结节状环形钙化.14例EGIST中,有4例发现肝脏转移,4例淋巴结转移,1例侵犯邻近器官.结论胃肠道外间质瘤与胃肠道间质瘤病理组织来源相似,故有着相似的影像表现,但因发生部位及生长方式不同,胃肠外间质瘤有其特有的影像学表现及临床预后.
목적분석위장도외간질류적CT표현,제고해류진단수평.방법회고성분석14례경수술화병이학증실적위장도외간질류CT적표현.결과14례종류중발생우망막2례,복막후5례,장계막7례,종괴다발자3례.종괴직경약위3~200 mm지간.CT평소병조정소결절상、류원형혹분협상,4례병조여주위장관분계청,1례평소밀도균균CT치약위31 HU,증강동맥기명현강화,CT치약위50~60 HU,내미견배사;10례병조여주위장관부분점련,부분분계청,형태위불규칙형급류원형,종괴평소정불균균저밀도,실성부분저우기육밀도,내가견반편상、편상급대편상배사구,실성부분CT치약위30~42 HU,증강후정경중도、현저불균균성강화,CT치약위50~90 HU,병조중앙경저밀도낭변배사구미견명현강화;기중1례병조실성부분가견소허분포적침첨양개화점,령1례종괴변연다발소결절상배형개화.14례EGIST중,유4례발현간장전이,4례림파결전이,1례침범린근기관.결론위장도외간질류여위장도간질류병리조직래원상사,고유착상사적영상표현,단인발생부위급생장방식불동,위장외간질류유기특유적영상학표현급림상예후.
Objective To analyze the CT features of extra-gastrointestinal stromal tumors(EGIST).Methods CT of 14 patients with histologically confirmed EGIST was analyzed retrospectively.Results The tumors were located in the mesentery(7), retroperitoneum(5)and omentum(2)with tumor size ranging from 3 to 200 mm.Multiple masses were found in 3 patients.CT showed small round or oval nodules with clear delineation from the adjacent bowel in 4 patients and irregular or round masses adherent to surrounding intestine in 10 patients.One tumor mass showed homogeneous CT density of 31 HU with contrast enhancement to 50-60 HU.The remaining tumors were heterogeneous with CT densities of 30-42 HU with heterogeneous contrast enhancement to 50-90 HU and non-enhancing central necrosis.Punctate calcifications were noted in one solid tumor and small annular calcifications were found in the periphery of one tumor mass.There were liver metastasis(4),lymph node metastasis(4),and local invasion(1).Conclusions EGIST are histologically identical to GIST.Because of the different locations and growth patterns,EGIST have variable imaging features and clinical prognosis.