64层CT对小肠间质肿瘤诊疗意义及病理对照研究  

Diagnostic value of stromal tumors in small intestine by 64 row CT,MPR,3D-CTA and the pathological control study

作　　者：单裕清[1] 延宏[1] 徐锐[1] 王雁冰[1] 李振家[2] 

机构地区：[1]山东省日照市人民医院医学影像科,山东日照276800 [2]山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2011年第9期1358-1361,共4页Journal of Medical Imaging

摘　　要：目的:应用多层螺旋CT小肠造影(MDCTE)、MPR及3D-CTA,分析小肠原发性间质瘤的CT表现特征及其应用价值。方法:回顾性分析11例经病理及免疫组化证实单发小肠间质瘤口服2.5%等渗甘露醇的肿瘤表现和造影方法及三维血供表现。CT特征包括肿瘤位置、大小、形态、血供、强化特征、转移等。结果:11例小肠间质瘤中,十二指肠1例、空肠4例,回肠4例,十二指肠空肠移行部2例。其中高危险度间质瘤5例,中危险度间质瘤3例,低危险度间质瘤2例,极低危险度间质瘤1例。发现肠系膜上动脉及其分支供血7例。与肠系膜上动脉分支血管密切相关3例,血供不明来缘1例。CT发现肿瘤坏死6例(58.5%),侵犯周围结构4例(27%),转移2例(22%)。肿瘤以肠腔外生长为主,平均直径6.0cm。未见肠梗阻征象。结论:CT小肠造影及MPR重建在小肠间质瘤的检出及定位方面有重要作用,能准确反应病变的生物学行为,对小肠间质瘤的定性分级有重要价值。小肠3D-CTA对于肿瘤的定性、定位、手术治疗方式的制定均有确切的临床意义。Objective：To apply MDCTE,MPR and 3 D –CTA;analysis of primary small intestinal-mesenchymal tumor CT performance characteristics and application value.Methods：Retrospective analysis 11 cases by pathological and immunohistochemical single small intestine that mesenchymal tumor oral 2.5% of mannitol tumor infiltration performance and imaging method and 3 d blood for performance.Ten of these cases have complete CT images material,CT features include a tumor location,size,shape,blood supply,and strengthen the characteristics,transfer,etc.Results：11 cases of small intestinal stromal tumor,duodenal,1 case of jejunum,ileum in 4 cases,the duodenum jejunum transitions department in 2 cases.The high risk of mesenchymal tumor in 5 cases,mesenchymal tumor risk in 3 cases,low risk stromal tumor in 2 cases,an extremely low risk stromal tumor in one.Find the superior mesenteric artery blood and its branch in 7 cases.And the superior mesenteric artery branch is closely related to blood vessels in 3,blood supply to margin in one.Unknown CT found tumor necrosis 6 patients（58.5%）,infringe upon structure around 4 cases（27%）,transfer in two（22%）.Tumor growth is given priority to,the neck to the average 6.0 cm in diameter.Did not see signs of intestinal obstruction.Conclusion：CT angiography and small intestine MPR reconstruction in small intestine stromal tumor detection and location of a major role in the disease,can accurate response to the small biological behaviour,mesenchymal tumor qualitative classification are of great value.Small bowel 3 D-CTA for tumor qualitative,location,surgical treatment for all have the exact the clinical significance.

关 键 词：胃肠间质瘤 小肠 体层摄影术 X线计算机 

分 类 号：R735.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]