食管间质瘤影像学分析及病理对照  

Esophageal stromal tumors:comparison of radiologic findings and pathology

作　　者：刘戬[1] 王铸[1] 屈东[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院影像诊断科,北京100021

出　　处：《中国肿瘤临床与康复》2012年第1期19-23,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的总结食管间质瘤的临床及影像学特点,探讨食管造影及CT(计算机体层成像)对其诊断价值。方法回顾性分析经手术病理证实的12例食管间质瘤的临床资料、食管造影及CT所见并将其与手术、病理所见进行对照,探究食管间质瘤食管造影及CT的影像学特点及其病理学基础。结果 12例患者共检出病灶13个,11例为单发病灶,1例为2个病灶。13个病灶中,4例为极低度侵袭危险性肿瘤,4个为低度侵袭危险性肿瘤,1个为中度侵袭危险性肿瘤,4个为高度侵袭危险性肿瘤。食管极低度侵袭危险性及低度侵袭危险性间质瘤造影表现为食管弧形外压性改变或较光滑充盈缺损,CT平扫表现为类圆形均匀软组织密度影,增强后均匀轻度强化。而中度及高度侵袭危险性间质瘤食管造影可见食管管壁僵硬,黏膜有破坏,CT扫描内部可见囊变坏死,增强扫描呈不规则强化。结论不同侵袭危险性的食管间质瘤影像学表现有一定差异,食管造影及CT对食管间质瘤的诊断及侵袭危险性分级有一定价值,但最终确诊要依靠病理学诊断。Objective Analyze the clinical and imaging feature of esophagus stromal tumor to approach the diagnostic value of esophageal imaging and CT （computed tomography） to esophageal stromal tumors. Methods A retrospective analysis about 12 pathologically confirmed cases of esophageal stromal tumors of the clinical data, and esophageal imaging and CT findings with surgical and pathological findings were compared to explore the esophagus imaging and CT angiography features with relation to pathological basis. Results 12 patients with 13 lesions were detected, 11 cases of single lesion, 1 case of 2 lesions. Within 13 lesions, there are 4 cases for very low degree of risk of tumor invasion, four for the low risk of tumor invasion, one of amoderate risk of tumor invasion, four for high risk of tumor invasion. Esophageal stromal tumors with very low and low degree of risk of invasion performance of the external pressure of the e- sophagus changes or curved over smooth filling defect on esophageal imaging, and show round-homogeneous soft tissue density, mild enhanced on CT scan. Esophageal stromal tumors with moderate and high risk of invasion show esophageal wall stiffness and mucosa damage on esophageal imaging, and can be seen the cystic necrosis and irregular enhancement on CT scan. Conclusion Esophageal stromal tumors of different risk of invasion have some differences on esophageal imaging and CT, which is valuable for the diagnosis of esophageal stromal tumor and classification of risk of invasion, but the final diagnosis depends on pathologic diagnosis.

关 键 词：食管肿瘤 诊断 实验医学 

分 类 号：R735.1[医药卫生—肿瘤] R730.2[医药卫生—临床医学]