MRI对胃肠道间质瘤诊断和侵袭危险度的评估价值  

Diagnosis and Aggressive Risk of Gastrointestinal Stromal Tumors:MRI Evaluation

作　　者：徐熠琳[1] 李小康[1] 刘佩芳[1] 曹文枫[2] 鲍润贤[1] 

机构地区：[1]天津医科大学附属肿瘤医院放射科,300060 [2]天津医科大学附属肿瘤医院病理科,300060

出　　处：《临床放射学杂志》2011年第3期373-377,共5页Journal of Clinical Radiology

摘　　要：目的探讨MRI对胃肠道间质瘤(gastrointestinal stromal tumors,GIST)诊断和侵袭危险度的评估价值。资料与方法回顾性分析经手术病理和免疫组织化学检查证实的27例GIST患者资料,病理上依据病变大小和有丝分裂率分为低危、中危、高危三组。MR图像分析包括病变的部位、大小、形态、边界、平扫信号强度、动态增强表现、扩散加权成像(DWI)上表观扩散系数(ADC)值,以及有无周围侵犯及远处转移,并将MRI上述征象与各侵袭危险组做进一步相关性分析。结果 27例GIST中,低危11例,中危6例,高危10例。形态不规则、边界不清、信号不均匀、周围侵犯及远处转移的例数随着低危、中危、高危的顺序而逐渐增多。动态增强检查,27例GIST中22例时间-信号强度曲线呈渐增型,5例呈延迟期轻度流出型,曲线类型在低、中、高危三组之间无明显统计学差异(P>0.05)。高危组GIST的ADC值为(1.127±0.205)×10-3 mm2/s,中危组ADC值为(1.436±0.254)×10-3 mm2/s,低危组ADC值为(1.478±0.344)×10-3 mm2/s,高危组ADC值明显低于中危和低危组,差异具有统计学意义(P<0.05)。结论 GIST在MRI平扫、增强扫描表现和DWI上ADC值有助于术前诊断和对GIST侵袭危险度的评估。Objective To analyze the value of MR imaging in the diagnosis and evaluation of aggressive risk in gastrointestinal stromal tumors.Materials and Methods Twenty seven cases of GIST confirmed by histopathology were reviewed retrospectively.According to the size and mitosis rate of lesion,27 cases were classified to low risk,mid risk and high risk groups.MRI features,included the site,size,shape,margin,uniformity,enhancement pattern,the ADC values on DWI,invasion and metastasis were evaluated.The MRI findings were compared with the aggressive risk.Results Among the 27 cases,11 were low risk GIST,6 mid risk GIST,10 high risk GIST.GIST with higher aggressive risk were more likely to have irregular shape,ill defined margin,heterogeneous signal intensity on MRI images,invasion and metastasis.The time signal intensity curve（TIC）of tumors on MRI appeared as persistent enhancing pattern in 22 cases,rapid enhanced and slow washout on delayed images pattern in 5 cases.The TIC patterns between the three groups showed no statistically significant difference（P0.05）.The ADC values of high/mid/low risk GIST were [（1.127±0.205）×10-3 mm2/s],[（1.436±0.344）×10-3 mm2/s] and [（1.478±0.254）×10-3 mm2/s],respectively.The ADC values of high-risk GIST were lower than that of the other two groups,and there was statiscally significant difference between high risk and mid/low risk groups（P0.05）.Conclusion MR imaging and ADC values on DWI have a potential role in diagnosing and evaluating the aggressive risk of GIST before surgery.

关 键 词：胃肠道间质瘤 侵袭危险度 磁共振成像 

分 类 号：R735[医药卫生—肿瘤]