胃肠道神经鞘瘤和间质瘤的螺旋CT表现及对照研究  

Imaging Findings and Comparative Study of Gastrointestinal Schwannomas and Gastric Gastrointestinal Stromal Tumors on Helical CT

作　　者：邢伟[1] 谭华桥[2] 俞胜男[1] 吴小凤[1] 孙益芳[1] 邱建国[1] 

机构地区：[1]苏州大学附属第三医院,常州市第一人民医院放射科,213003 [2]上海交通大学附属第六人民医院放射科

出　　处：《临床放射学杂志》2006年第6期538-542,共5页Journal of Clinical Radiology

摘　　要：目的研究胃肠道神经鞘瘤的螺旋CT表现,并与胃肠道间质瘤(GIST)进行对照分析。资料与方法选取经手术病理证实的胃肠道神经鞘瘤12例及GIST34例,回顾性分析其临床特征及螺旋CT表现,并对其螺旋CT表现加以比较。CT影像资料由两名具有丰富经验的高年资放射科医师评估,评估内容包括肿瘤大小、形态、生长方式、增强模式、强化程度、肿瘤与黏膜接触面溃疡情况。统计学分析采用单因素方差分析、q检验和卡方检验。结果良性GIST最大直径小于胃肠道神经鞘瘤和恶性GIST(P<0.05)。胃肠道神经鞘瘤(83.3%)和良性GIST(80%)多呈圆形或卵圆形,而恶性GIST(84%)多呈分叶状或不规则形,胃肠道神经鞘瘤和良性GIST与恶性GIST肿瘤形态之间差异有显著性。胃肠道神经鞘瘤和良、恶性GIST均可呈腔内生长、腔外生长、腔内外生长,其生长方式三者之间差异无统计学意义(P<0.05)。胃肠道神经鞘瘤和良性GIST增强模式、强化程度与恶性GIST肿瘤之间差异有统计学意义(P<0.05)。恶性GIST溃疡(28%)比胃肠道神经鞘瘤(25%)和良性GIST(20%)更常见,但统计学上无显著性差异(P>0.05)。结论胃肠道神经鞘瘤CT上多表现为圆形、卵圆形/扁圆形的匀质肿块,强化不明显或呈轻度强化,该表现类似于良性GIST,但与恶性GIST影像学表现有所不同。Objective To investigate CT findings of gastrointestinal schwannomas, and compare these findings with those of gastrointestinal stromal tumors（GIST）. Materials and Methods 12 cases of gastrointestinal schwannomas and 34 gastrointestinal stromal tumors（ 10 benign and 24 malignant） proven surgically and pathologically were included, The clinical features and CT find- ings of both with regard to the size, contour, margin, growth type, contrast enhancement pattern, contrast enhanced degree,presence or absence of ulcer were retrospectively reviewed and the latter were compared by two experienced radiologistso The statistical significance was evaluated by using 95% confidence interval, one-way ANOVA, q test and chi square test. Results The diameter of benign GISTs were significantly smaller than that of gastrointestinal schwannomas and malignant GIST （mean ± SD, 3.6±1.27, 6.0 ± 2.49, 7.8 ±3.56, respectively） （ P 〈 0.05）, The contour was round or oval in most of both gastrointestinal schwannomas and benign GISTs （83.3% and 80%, respectively）, but lobulated in malignant GISTs （84%）, There was significant difference in shape between gastrointestinal schwannomas and GISTs. Growth types in schwannomas and GISTs were diverse as endoluminal, exogastric, or both, with no statistical difference （ P 〉 0.05 ）. There was significant difference in model and extent of enhancement between gastrointestinal schwannomas, benign GISTs and malignant GISTs （ P 〈 0.05 ）. Ulcer in malignant GISTs （28%） was more common than that in gastrointestinal schwannomas, （25%）, benign GISTs （20%）, but without statistical difference （P 〉0.05）. Conclusion Most gastrointestinal schwannomas are appeared as round, and homogeneous solid tumors with slight or nonenhancement on CT, these CT findings are very similar to those of benign GISTs, but distinguishable from those of malignant GISTs.

关 键 词：胃肠道 间质瘤 神经鞘瘤 体层摄影术 X线计算机 

分 类 号：R735[医药卫生—肿瘤] R734.2[医药卫生—临床医学]