胃肠道平滑肌肉瘤的临床及影像学诊断价值  

Clinical and imaging diagnostic value of gastrointestinal leiomyosarcomas

作　　者：李春卫[1] 武乐斌[1] 刘村[2] 林祥涛[1] 许玉军[1] 

机构地区：[1]山东大学山东省医学影像学研究所,山东济南250021 [2]山东大学济南市中心医院,山东济南250013

出　　处：《医学影像学杂志》2006年第11期1192-1195,共4页Journal of Medical Imaging

摘　　要：目的：探讨胃肠道平滑肌肉瘤的临床及影像学诊断特征。方法：对46例经手术病理证实的胃肠道平滑肌肉瘤的起源。大小、形态进行回顾性分析。结果：X线检查：22例胃平滑肌肉瘤：23例小肠平滑肌肉瘤；1例结肠平滑肌肉瘤。胃平滑肌肉瘤14／22例病变位于腔内，2／22例病变位于腔外。6／22例病变位于腔内外；小肠平滑肌肉瘤19／23例病变位于腔外，2例位于腔内，2例位于腔内外。其大小多在6-10cm；16例边缘有分叶征象，有溃疡者22例；1例结肠平滑肌肉瘤位于腔 内外，B超表现为腹腔内实性肿块；CT平扫多呈不规则分叶状，内部密度多不均匀，增强扫描呈肿瘤实质部明显强化，坏死区无强化。结论：胃肠道平滑肌肉瘤好发于胃及空肠，胃平滑肌肉瘤以腔内型居多；小肠平滑肌肉瘤以腔外型居多，综合应用消化道气钡双重造影检查、CT、B超检查及血管造影检查能提高胃肠平滑肌肉瘤的诊断水平。Objective：To evaluate the clinical and imagine diagnosis features of gastrointestinal leiomyosarcomas. Methods：Retrospective analysis the genesis, size, modality of 46 cases of gastrointestinal leiomyosarcomas which were proved by histologically. Results： Undergoing X-ray there were gastric leiomyosarcomas （22 cases）, intestinal leiomyosarcomas （23 cases）, colonic leiomyosarcoma （1 case）. There were 14 cases intraluminal of stomach, 2 cases extraluminal of stomach,6 cases intra-and extra-luminal of stomach, 19 cases extra- luminal in intestine, 2 cases intraluminal of intestine, and 2 cases intra-and extra-luminal of intestine, the sizes of lesions were between 6 and 10cm, and the margin of the tumor mass was multiloculated-shaped in 16 cases, There were ulcers in 22 cases; One case was intra- and extra-luminal of colonic leiomyosarcoma. The tumor mass were solid mass in B-mode ultrasonography, and irregular and multiloculated-shaped, inhomogeneous density, after injection of contrast media the density of essential part enhanced and the density of necrosis part unchanged in computed tomography. Conclusion：Gastrointestinal leiomyosarcomas were mainly occur in stomach and jejunum. The most part of gastric leiomyosareomas were intraluminal, on the contrast, the most part of intestinal leiomyosarcomas were extraluminal. The combination of the X-ray barium radiography, computed tomography, B-mode ultrasonography can improve the diagnosis level of the gastrointestinal leiomyosareomas.

关 键 词：小肠 结肠 平滑肌肉瘤 临床 影像学 诊断 

分 类 号：R574[医药卫生—消化系统] R445[医药卫生—内科学]