宝石CT能谱成像对胃间质瘤的诊断价值  

Gemstone Spectral CT Imaging in Diagnosis of Gastric Stromal Tumor

作　　者：张旭婷[1] 刘琪[1] 郝雅静[1] 靳宏星[1] 任基伟[1] 

机构地区：[1]山西医科大学附属肿瘤医院,山西太原030013

出　　处：《中国医学影像学杂志》2015年第4期264-267,共4页Chinese Journal of Medical Imaging

摘　　要：目的：分析胃间质瘤（GST）的宝石 CT 能谱表现，探讨宝石 CT 能谱对其诊断与鉴别诊断的应用价值。资料与方法回顾性分析30例经手术病理证实并行宝石 CT 能谱成像扫描的 GST 患者的影像资料及相关临床资料，并通过测定病灶动脉期、静脉期的碘含量进行定量分析。结果 GST 的 CT 能谱表现为软组织肿块，病灶大小不一，向胃腔内或外或同时向腔内外突出，其中低危组肿瘤直径1-5 cm 4例；中危组肿瘤直径1-5 cm 3例，6-19 cm 3例；高危组肿瘤直径6-9 cm 18例，1-5 cm 2例，1例患者为大小不等的多发病灶。肿瘤发生在胃体部15例，胃窦部10例，胃底部4例，多灶性多部位生长1例。肿瘤腔内外生长16例，其中高危患者14例；腔外生长10例，其中高危患者6例，低危患者1例；腔内生长4例，其中低危患者3例。动脉期病灶轻度强化，静脉期病灶强化程度增加，病灶与正常胃壁动脉期及静脉期的碘含量及标准碘含量差异有统计学意义（F=378.6、296.6，P〈0.05）。病灶动脉期及静脉期能谱曲线斜率差异有统计学意义（t=-2.245，P〈0.05）。结论宝石 CT 能谱成像可以准确显示 GST 病灶的外部形态、内部改变，通过测定碘含量可提供肿瘤定量诊断信息，能够为临床提供更多有效的信息和依据。Purpose To investigate the CT gemstone spectral imaging features of gastric stromal tumors （GST）, so as to discuss the value of CT gemstone spectral imaging in the diagnosis and differential diagnosis of GST. Materials and Methods Thirty patients with GST proved pathologically were scanned by gemstone spectral imaging. Their GSI scanning image data and the related clinical data were retrospectively analyzed, and the quantitative analysis based on iodine content of the lesions in both arterial phase and portal phase was carried out. Results The GSI findings showed that the lesions were intra-luminal, extra-luminal or both intra-and extra-luminal soft tissue mass, the sizes were various, and they protruded either toward the inner side of stomach or the opposite or both. Among them, the diameter of 4 tumors in the low risk group ranged from 1 to 5 cm; in the intermediate risk group, 3 tumors had diameters from 1 to 5 cm, and 3 others were from 6 to 19 cm; in high-risk group, 18 tumors＇ diameter were between 6 to 9 cm, 2 were between I to 5 cm, and the rest 1 had multiple lesions in various sizes. Fifteen tumors occurred in gastric body, 10 occurred in gastric antrum, 4 were at the bottom of the stomach, and I had multifocal growth. Sixteen patients had internal and external growth of lesions, among whom 14 patients were at high risk; 10 patients＇ lesions were outside the cavity, including 6 patients at high risk and 1 patient at low risk; and 4 patients had lesions inside the cavity, including 3 patients at low risk. At the arterial phase the foci mildly strengthened, and they strengthened increasingly at the portal phase. The material value based water and iodine figure showed that material value based iodine of the lesions at both arterial phase and portal phase was higher than that in the normal gastric wall tissue, and the material value based iodine of the lesions at portal phase was higher than that at arterial phase （F=378.6 and 296.6, P〈0.05）. At arterial phase, the iodine content of the lesion

关 键 词：胃肿瘤 间皮瘤 体层摄影术 X 线计算机 诊断 鉴别 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]