恶性胃肠道间质瘤的MRI特点26例分析  

An analysis of MRI features in 26 cases with malignant gastrointestinal stromal tumor

作　　者：黄彬[1] 程红岩[1] 

机构地区：[1]上海第二军医大学东方肝胆外科医院放射科,上海200433

出　　处：《世界最新医学信息文摘》2013年第12期11-12,共2页World Latest Medicine Information Electronic Version

摘　　要：目的探讨MRI对恶性胃肠道间质瘤（MGIST）的诊断价值。方法回顾性分析26例经手术病理证实的MGIST的MRI表现并与病理对照。结果肿瘤位于胃部10例，小肠9例，直肠4例，小肠系膜3例。MGIST的影像学表现有以下特点：①肿瘤多位于胃、小肠，最大径〉10cm（小肠5cm），外生性居多，与周围脏器分界不清；直径（5cm（小肠2cm），肿瘤边界清楚，能明确部位；②病灶表现为T1WI呈稍低信号，T2WI呈较高信号，增强后延迟期强化显著；③肿瘤最大径〉10cm（小肠5cm）时有不同程度的出血、坏死囊变，而坏死囊变区往往无强化；④以肝脏转移为主，少数腹腔转移，肝脏转移瘤以坏死、囊变或瘤内分层样变为典型，罕见出血。结论MGIST在MRI表现有一定的特征，MRI检查有助于与其他肿瘤区分，提高该疾病的诊断的准确性。Objective To investigate the MRI features of malignant gastrointestinal stromal tumors （ MGIST ） . Methods The MRI features were retrospectively analyzed in 26 cases of MGIST proved by operation and pathology. Results The tumors originated from the stomach（n=10）, small bowl（n=9）, colon（n=4）, small intestine mesentery（n=3）. The MRI characteristiscs of malignant GISTs were as follow： （1） MGISTs usually be found in stomach and small intestine. Those ones have greatest dimensions bigger than 10cm（5cm in small intestine） are mostly exogenous and have blurry boundaries with surrounding visceras; the ones have greatest dimensions less than 5cm（2cm in in small intestine） have clear boundaries with surrounding visceras and can be located precisely. （2） The lesions＇ T1WI have lower signals while T2WI have higher signals. （3） There are bleedings and necrosis or cystic change in different degrees when the MGISTs＇ greatest dimensions are larger than 10cm（5cm in small intestine）. （4） MGIST mostly divert to liver, some to abdomen. Tumors diverted in liver typically with necrosis, cystic change or intratumorally layer-shaped change, rarely with bleedings. Conclusion Malignant gastrointestinal stromal tumors are characteristic in MRI,and MRI can help to discriminate it from other tumors, as well as enhancing the accuracy of diacrisis.

关 键 词：胃肠道 间质瘤 恶性 磁共振成像 体层摄像术 X线计算机 

分 类 号：R445[医药卫生—影像医学与核医学]