胃肠道间质瘤18例的^(18)F-FDG PET/CT显像及病理对照研究  

Correlation Research in 18F-FDG PET/CT Imaging and Pathology of 18 Gastrointestinal Stromal Tumors

作　　者：赵春雷[1] 陈自谦[1] 钱根年[1] 李天然[1] 王楷堂[1] 李铭山[1] 

机构地区：[1]解放军南京军区福州总医院医学影像科PET/CT中心,福建福州350025

出　　处：《临床军医杂志》2009年第2期269-271,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨胃肠道间质瘤的18F-FDG PET/CT显像特点及其相应病理学表现,以提高对胃肠道间质瘤的诊断水平。方法对18例病理证实为胃肠道间质瘤患者的PET/CT显像进行回顾性分析,记录、总结病灶特点,并与既往PET/CT报告及病理报告进行比较、分析。结果本组18例间质瘤,原发瘤灶均为单发,其中良性3例、潜在恶性5例、恶性10例,3例良性病变PET显像均为阴性表现,潜在恶性及恶性间质瘤15例均表现为均匀或不均匀核素异常浓聚灶,CT表现3例良性间质瘤均表现为边界清楚、光滑肿块影,潜在恶性及恶性间质瘤CT表现不一,多数病灶内可见坏死、囊变区,部分病灶内可见出血,少部分病灶内密度均匀,呈软组织密度;大部分病例可准确定位、定性诊断,少数病例定位诊断及病理学分型不明确。结论PET/CT在对间质瘤的定位及定性诊断方面具有重要价值,可鉴别间质瘤良、恶性,且一次扫描可判断肿瘤有无转移,但对于间质瘤恶性程度分级上还有一定困难,最后确诊有赖于病理组织学和免疫组化检查。Objective To evaluate the 18F-FDG PET/CT imaging of gastrointestinal stromal tumor （GIST） with corresponding pathology diagnoses. Methods The PET/CT imaging findings of 18 patients with GIST proved by operation and pathology were retrospectively analyzed and compared with previous PET/CT and pathology reports. Results All the primary tumors of the 18 ones were single. Of the 18 eases, 3 were benign, 5 were potentially malignant, and 10 were malignant. The 3 eases of benign GIST were negative in PET/CT imaging findings （ no higher concentration of radionuelide in the lesions） , the 15 cases of potentially malignant or malignant GIST were positive in PET/CT imaging findings （ with higher concentration of radionuclide）. The 3 of benign GIST revealed masses with clear margins in CT imaging findings. In the 15 eases of potentially malignant and of malignant GIST, intra-tu- morous necrosis, hemorrhage or cystic changes were found in most and the rests of the tumors showed even soft - tissue density. Most GIST cases in this group could be precisely localized and qualitatively diagnosed in PET/CT imaging, except a few of the cases. Conclusion PET/CT is a useful imaging technique in the precisely localizing and qualitative diagnosis of GIST. It can differentiate the benign from the malignant GIST, and detect the tumor metastasis in one PET/CT scan. There＇re still some difficulties in differentiating the potentially malignant with the malignant GIST. In this case, it is histopathological and immunohistochemical examination we depend on to make a final confirmation.

关 键 词：胃肠道间质瘤 发射型计算机体层摄影术 X线计算机体层摄影术 脱氧葡萄糖 病理学 

分 类 号：R735[医药卫生—肿瘤]