小肠中高危险度间质瘤影像学观察及临床病理对照分析.docVIP

小肠中高危险度间质瘤影像学观察及临床病理对照分析【摘要】 目的 探讨小肠中高危险度恶性间质肿瘤(GIST)影像学特征及诊断价值。方法 回顾性分析经手术病理证实的21例中高度危险度小肠GIST的影像学资料,所有病例均行免疫组织化学检测。结果 21例中,11例GIST中度危险度,10例高度危险度。肿瘤大小5.1～7.9 cm,平均6.4 cm。CT检查为肠腔偏侧性狭窄、腔外不规则肿块、肿块内多灶性低密度坏死区、明显的不均匀强化。结论 中高危险度GIST影像学表现具有一定的特征性,一般直径大于5 cm,沿长轴偏侧性狭窄伴多发性溃疡、不规则腔外肿块、肿块内多处低密度区征象、增强扫描有明显的不均匀强化,CT检查是小肠中高度危险度GIST主要影像学方法。? 【关键词】 小肠;间质瘤;体层摄影术;X线计算机;免疫组织化学?? The study of imaging findings and clinic-pathological of high risk gastrointestinal stromal tumor of small intestine YAN Hong,QIN Tao,WANG Gang-ping. Department of Radioology, The People’s Hospital of Rizhao City, Rizhao 276826, China 【Abstract】 Objective To investigate the imaging findings high risk Gastrointestinal stromal tumor(GIST) of small intestine.Methods The clinical and imaging data of 21 patients with moderate and high risk GISTs of small intestine which were diagnosed surgically and pathologically were analyzed and summarized.All cases weredetected by S-P method. Results The tumors included 11 moderate risk and 10 and high risk GISTs. The diameter varied from 5.1 to 7.9 cm,the average size was 6.4 cm. The main signs of CT scans was partial lumen stenosis,an extraluminal mass with multiple necrosis areas of low density. Conclusion Helical CT scan are the major imaging techniques in the determination moderate and high risk GISTs of small intestine. The appearances include imperfect lumen and the irregular tumor with multiulcerations or low density regions and inhomoneneous enhancement.? 【Key words】 Small intestine;Stromal tumor;Tomonraphy;X-ray computed;Immunohistochemistry ? DOI:10.3760/cma.j.issn 1673-8799.2010.11.51? 作者单位:276826 山东省日照市人民医院CT室(延宏);港口医院(秦涛),病理科(王刚平) 胃肠间质瘤(gastrointestinal stromal tumors,GISTs)具有广谱生物学行为[1],对于临床表现为典型恶性者可直接诊断为恶性GIST,而对于局限性GIST生物学行为的评估,宜以危险程度代替良恶性[2]。为探讨小肠GIST影像学特征,我们对21例中高危险度GISTs进行了回顾性分析,报告如下。? 1 资料与方法? 收集2000年1月至2009年12月间手术切除病理学证实的21例小肠中高危GISTs作研究,应用免疫组织化学S-P法检测CD117、CD34、S-100和SMA确诊。21例中男14例,女7例,年龄28～71岁,平均54岁。临床表现为腹包块9例,腹痛11例,消化