胃间质瘤螺旋CT诊断研究.docVIP

胃间质瘤螺旋CT诊断研究【中图分类号】R814.42【文献标识码】A【文章编号】1672－3783(2011)08－0303－01 【摘要】目的：探讨胃间质瘤（GST）的CT特征，提高诊断准确率。方法：回顾性分析经手术和病理证实的16例GST的CT平扫和增强表现。结果：16例GST腔内型4例，腔外型7例，腔内外生长者5例。其中良性GST5例，恶性11例，其中3例伴有肝脏多发转移。CT 平扫均为单发软组织肿块，良性病灶密度均匀,强化较均匀；恶性者密度不均匀，可伴有出血、坏死、囊变，增强扫描后实性部分中度至明显强化，且静脉期病灶的强化密度高于动脉期。结论：GST的CT表现有明显的特征性, CT检查对其定位、良恶性及疗效的判断有较高的价值。 【关键词】胃：间质瘤：CT CT diagnosis of gastric stromal tumor ZHANG Hai-xia 1,LIU Feng 2 【Abstrust】Objective: To discuss the specific features of CT in the diagnosis of GST, improve the diagnostic accuracy of GST. Methods: The CT imaging with plain and contrast enhanced scan were reviewed and analyzed in 16 patients with GST confirmed postoperatively and pathologically. Results: The growth pattern of 16 cases GST including 4 intraluminal cases and 7 exophytic cases and 5 mixed cases. There were 5 benign cases and 11 m alignant cases，including 3 cases in liver disseminated metastasis.16 lesions were solitary in plain CT scan image. The benign tumors displayed homogeneous density and homogeneous enhancement, whereas the m alignant were heterogeneous density ，together with hemorrhage, necrosis and cystolization. The solid tumor was characterized by moderate or enhanced imaging with contrast enhanced scan, which was best visualized in venous phase. Conclusion the CT imaging features of GST have much characteristics. CT examination has high value in detecting its location, and in evaluating its characteristics the benign from the m alignant tumors and treatment. 【Key words】stomach; stromal tumor 胃肠道间质瘤可能起源于胃肠间质的星形胶质细胞,有着特殊的免疫表型及组织学特点,具有多向分化的特征,可以向平滑肌、神经分化或不定向分化,是一种具有恶性潜能的胃肠道黏膜下肿瘤。免疫组化发现GST的CD34、CD117的表达较高,其中以CD117更为敏感。本文搜集了经病理证实的16例GST，目的在于探讨GST的CT诊断价值。? 1 材料与方法 1.1 临床资料 16例GST男10例，女6例，年龄22～75岁，平均45.2岁。本组病例上腹不适、腹痛9例，上消化道出血 7例，其中伴有恶心、呕吐4例，腹部包块2例。 1.2 检查方法 使用GE公司的GE Hispeed双排螺旋CT扫描，采用层厚10mm，层间距10mm连续扫描，5mm重建，常规CT平扫及双期增强扫描。扫描前禁食6～8小时，检查前30分钟口服1%-3%泛影葡胺1000ml。增强方法：用高压注射器经肘静脉注入欧苏80～100ml，注射速率为2.5ml/s,动脉期延迟25s扫描,静脉期延迟60s扫描。? 2 结果 2.1 1