CT对胃肠道间质瘤的诊断和临床应用价值.docVIP

CT对胃肠道间质瘤的诊断和临床应用价值 　　【摘要】 目的：分析胃肠道间质瘤的CT表现和特征，探讨其临床应用价值。方法：回顾性分析经手术病理、免疫组化证实的25例胃肠道间质瘤CT平扫和增强的影像征象。结果：25例胃肠道间质瘤患者中，胃间质瘤18例，十二指肠间质瘤3例，食道间质瘤1例，结肠间质瘤2例，直肠间质瘤1例；根据肿瘤的部位、大小、形态、密度、边界、与周围组织关系、CT增强特征、异常血管、转移灶等，正确诊断胃肠道间质瘤23例，2例误诊为平滑肌瘤；25例患者按危险度分级，CT/病理诊断比较，低度危险性8/10例，中度危险性12/10例，高度危险性5/5例。结论：CT检查对胃肠道间质瘤的诊断有较高价值，并有助于肿瘤的危险度分级，为临床的治疗和手术方式的选择提供给了重要的参考依据，确诊仍需免疫组化检查。 中国论文网 /6/view-7165056.htm 　　【关键词】 胃肠道间质瘤； 多层螺旋CT； 诊断 　　中图分类号 R735 文献标识码 A 文章编号 1674-6805（2015）25-0009-03 　　【Abstract】 Objective：To investigate the clinical application value of CT findings in diagnosing gastrointestinal stromal tumor.Method：A retrospective analysis of plain and enhanced spiral CT findings was performed in 25 patients with pathologically confirmed gastmintestinal stromal tumor.Result：In 25 cases，18 cases of originated stomach，3 cases of duodenum，1 case of esophagus，2 cases of colon and 1 case of rectum.23 cases were diagnosed properly as gastmintestinal stromal tumors based on the location，size，shape，density，range，encroachment of other organs，enhancement pattern，abnormal vessels and metastasis of tumors，while 2 cases were misdiagnosed as leiomyoma.Compared CT findings with pathological diagnosis，the risk stratifications of 25 cases were as follows：8/10 cases in low-risk，12/10 cases in intermediate-risk，5/5 cases in high-risk.Conclusion：CT exhibites the highly clinical application value in the diagnosis of gastmintestinal stromal tumors.And CT is also helpful on the risk stratifications of the tumors.It provides an important evidence for clinical treatment and the selection of surgical approach.However，the immunohistochemistry is still an essential tool in the proper diagnosis. 　　【Key words】 Gastrointestinal stromal tumor； Multilayer spiral CT； Diagnosis 　　First-authors address：Shijingshan Hospital，Teaching Hospital of Capital Medical University，Beijing 100043，China 　　doi：10.14033/ki.cfmr.2015.25.004 　　间质瘤是来源于原始间质细胞的非定向分化的肿瘤，可发生在胃肠道全长范围和网膜、肠系膜、腹膜及腹膜后区，分为胃肠道内和胃肠道外两型。本研究回顾性分析经手术病理确诊的25例胃肠道间质瘤（gast