多种影像学检查方法对腔外型胃肠道间质瘤的诊断价值探讨  

The diagnostic value in extraluminal type gastrointestinal stromal tumors by various imaging examination methods

作　　者：班永光[1] 栾钦花[2] 李吉昌[1] 滕剑波[1] 宋庆达[1] 娄丽[1] 

机构地区：[1]山东省医学影像学研究所超声诊断研究室,山东济南250021 [2]山东省医学影像学研究所X线诊断研究室,山东济南250021

出　　处：《医学影像学杂志》2013年第5期734-737,共4页Journal of Medical Imaging

摘　　要：目的探讨超声与其它多种影像学检查方法在腔外型胃肠道间质瘤中的诊断价值。方法回顾性分析27例经手术病理证实的腔外型胃肠道间质瘤患者的临床、病理及各种影像学表现特征。结果 27例经超声检查发现29个病灶,超声提示20个为胃肠道间质瘤,6个超声仅提示肿瘤存在,3个误诊为其它疾病;其中9例行CT检查发现9个病灶,7个提示为胃肠道间质瘤,1个仅提示恶性肿瘤,1个误诊为外生性胃癌;4例行MRI检查发现4个病灶,3个提示为胃肠道间质瘤,1个误诊为胰腺囊腺癌;6例行消化道钡餐检查均未发现明显具体病灶,3例提示胃肠道外压性改变,1例误诊为胃窦部溃疡并窦道形成,2例仅提示胃炎。腔外型胃肠道间质瘤具有较典型超声、CT和MRI表现,据囊实性成分多少分为3型:Ⅰ型实性,Ⅱ型囊实性以实性为主,Ⅲ型囊实性以囊性为主,其中Ⅱ型最多见,增强扫描时实性部分多不均匀性强化。结论彩色多普勒超声是腔外型胃肠道间质瘤的重要筛查手段,CT与MRI对其定位及定性具有重要价值,消化道钡餐检查诊断价值有限。Objective To explore the diagnostic value of ultrasound and other various imaging methods in extraluminal type gastrointestinal stromal tumors. Methods The clinical and pathological manifestations,the imaging characteristics of 27 surgically treated with histologically conformed extraluminal gastrointestinal stromal tumors （GISTs） were retrospec- tively analyzed. Results 29 tumors were found by ultrasound examination in 27 cases, of which 20 tumors were prompted for gastrointestinal stromal tumors, 6 tumors were only hinted, 3 tumors were misdiagnosed as other diseases. 9 tumors were found by CT examination in 9 cases, of which 7 tumors were prompted for gastrointestinal stromal tumors, 1 tumor was only prompted for malignant tumor, 1 tumor was misdiagnosed as exogenous gastric carcinoma. 4 tumors were found by MRI examination in 4 cases, of which 3 were prompted for gastrointestinal stromal tumors, 1 tumor was misdiagnosed as pancreatic cystadenocarcinoma. No significant specific lesions were found by digestive tract barium examination in 6 cases, of which 3 cases were found the oppression signs on gastrointestinal tract, 1 case was misdiagnosed as distal gastric ulcer with sinus, gastritis were only hinted in 2 cases. Extraluminal type gastrointestinal stromal tumors had a typical ultrasonogram CT and MRI performance. The tumors were divided into three types according to the composition： type l （solid）, type 1I （solid-cystic priority to solid）, type III （solid-cystic priority to cystic）, most of them were type ]I , the solid components were mostly enhanced inhomogeneously. Conclusion Color doppler ultrasound is the important screen- ing method in diagnosing extraluminal type gastrointestinal stromal tumors, CT and MRI have important value in confirming its location and property, while the digestive tract barium examination is limited.

关 键 词：胃肠道间质瘤 超声检查 体层摄影术 x线计算机 磁共振成像 

分 类 号：R735.2[医药卫生—肿瘤]