30例胃肠道间质瘤的影像检查分析  

30 cases of gastrointestinal stromal tumor imaging analysis

作　　者：高鹏宇 

机构地区：[1]陕西省核工业215医院,陕西咸阳712000

出　　处：《中外医学研究》2011年第19期1-4,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的探讨胃肠道间质瘤(GIST)的钡剂造影、选择性血管造影及CT扫描征象和影像表现。方法参照手术病理结果,对30例经病理证实分别为良性、交界性和恶性GIST的钡剂造影、血管造影及CT扫描的影像表现进行回顾性分析,总结不同性质的GIST在这三种检查中的影像表现特点。结果良性GIST:良性GIST向胃肠道腔内或腔内、外生长时,钡剂造影表现为腔内小充盈缺损(充盈相)或黏膜局限性"掀起"(黏膜相),蠕动波连续或出现逆蠕动,向腔外生长时则无明显影像表现;血管造影勾勒出的肿瘤轮廓较小,血供丰富,实质期均匀染色,但不能确定肿瘤的生长方式;CT平扫肿瘤体积小,密度均匀,增强扫描均匀强化。交界性GIST:钡剂造影可见充盈缺损区小龛影,局限蠕动波消失;血管造影显示肿瘤体积较大,瘤内血管粗细及染色不均,且有"分隔"现象;CT扫描密度不均或不均匀强化。恶性GIST:钡剂造影可见不规则龛影,边缘出现分叶迹象,局限壁僵硬或肠管移动度受限;血管造影显示肿瘤边缘不规则、模糊,血管湖或血管僵硬、不规则,肿瘤中心性或偏心性无染色区;CT扫描瘤体均大,主要呈壁间或向腔外生长为主,密度不均匀,有低密度坏死腔,增强不均匀。CT检查同时可发现远处脏器转移和邻近脏器侵犯,未见淋巴结转移。结论 GIST的胃肠道钡剂造影检查缺乏特征性,且受肿瘤生长方式的限制,但作为常规检查,在发现、定位和提出诊断等方面仍有一定意义。由于GIST多血供的特点,血管造影大部分能发现肿瘤并作出定性诊断,但其创伤性检查和费用高等缺点,限制了其难以作为常规检查手段。CT扫描对GIST诊断有特征性影像表现,在定位、定性等方面有较大的临床价值。Objective To investigate the gastrointestinal tumors（GIST） of barium,selective angiography and CT scan signs and imaging findings.Methods According to the pathological results of 30 cases were pathologically proved benign,borderline and malignant GIST,barium,angiography and CT scan imaging findings were retrospectively analyzed and summarized the different nature of these three checks GIST the performance characteristics of the image.Results GIST benign gastrointestinal lumen or cavity to the external growth,the barium showed a small filling defect cavity（filling phase） or mucous membrane limits ＂set off＂（mucous membrane phase）,continuous or peristaltic wave reverse peristalsis occurs,when the cavity was no significant growth of imaging findings;angiography outlines the contours of small tumor blood supply,the real stain on the uniform,but can not determine the tumor＇s growth pattern;CT scan of small tumor size,density uniform,homogeneous enhancement enhanced scan.Borderline GIST： barium shows a small filling defect Kanying,limitations peristaltic wave disappeared;angiography showed a larger tumor volume,tumor blood vessels uneven thickness and coloring,and a ＂separation＂ phenomenon;CT scan or uneven density heterogeneous enhancement.Malignant GIST： irregular Kanying barium can be seen,signs of marginal leaf emergence,thus limiting the intestinal wall stiffness or limited mobility;angiography showed irregular tumor margins,fuzzy,vascular lakes or vascular stiffness,irregular,central tumor or eccentric,no staining area;CT scan the tumor were large,mainly intramural or to the cavity was the main growth,uneven density,with low density necrotic cavity,enhanced uneven.CT examination also can be found in distant organ metastasis and adjacent organs violations.No lymph node metastasis.Conclusion GIST of the gastrointestinal tract barium examination of the lack of features,and tumor growth by way of limitation,but as a routine examination,in the discovery,diagnosis and other aspects of positioni

关 键 词：胃肠道间质瘤 消化道钡剂造影 选择性血管造影 CT扫描 

分 类 号：R735[医药卫生—肿瘤]