多层螺旋CT对直肠间质瘤的诊断价值  

Diagnositic Value of MSCT in the Diagnosis of Rectal Stromal Tumors

作　　者：刘琦[1] 徐凯[1] 荣玉涛[1] 鹿彩銮[1] 刘小华[1] 徐慧婷 

机构地区：[1]徐州医学院附属医院影像科,江苏徐州221000

出　　处：《中国CT和MRI杂志》2015年第10期87-89,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨多层螺旋CT对直肠间质瘤的临床诊断价值。方法回顾性分析自2011年12月至2014年10月经手术病理证实的10例直肠间质瘤的临床及CT检查资料。结果本组10例病例中9例直肠间质瘤均位于直肠中下段,1例位于直肠上段。肿瘤最大直径3.9-15.0cm,平均6.8cm,多数病灶表现为类圆形肿块(7/10),肿块边界清晰及边界不清者各占5例,7例呈外生型生长,肿瘤在CT平扫图像主要表现为不均匀密度,9例行增强检查病例中8例表现为不均匀强化,1例病灶中出现钙化,1例发现肝脏转移灶。所有病例盆腔内均未发现肿大淋巴结。显微镜下肿瘤均由梭形细胞构成,病理学评估高风险5例,低风险1例,4例未评估风险度。CD117阳性率100%,CD34阳性率90%。结论直肠间质瘤CT常表现为起源于直肠壁的外生型肿块,有明确的分界,增强多表现为不均匀强化,多平面重建能清楚显示肿瘤位置、起源、内部成分及周围结构受累情况,可以对肿瘤风险度进行初步预测,为临床治疗及随访提供有效的信息。Objective To investigate the diagnostic value of the MSCT performance in rectal stromal tumors.Methods The clinical and CT features of 10 RST cases which were confirmed by surgery and pathology from December 2011 to October 2014 were analyzed retrospectively.Results Nine cases of ten located in the middle-lower segment of rectum,only 1 case located in the upper segment.The maximum diameters were 3.9 ~ 15.0 cm with a average of 6.8cm,most lesions manifested round-like masses （7/10）,5 cases had clear boundary and the other had unclear boundary,7 cases were exophytic growth. Most cases showed heterogenous density in the non-enhanced CT images. And 8 cases showed heterogeneous enhancement after enhanced.Local calcification was found in one case.Liver metastasis was found in one case.No lymph node metastasis was detected in 10 cases.All the RSTs were made by spindle cells,five high-risk cases and one low-risk case were evaluated patholoically,the risk-degree in four cases were not assessed. Immunohistochemistry showed CD117 positive rate of 100% and CD34 positive rate of 90%.Conclusion The relative characteristic CT fingings of RSTs include a well-defined exophytic mass closely related with the rectum,and with heterogenous enhancement after enhanced.The location, origin, components and surrounding structures of the tumor could be clearly demonstrated in Multiplanar reconstruction （MPR） imaging, which provide a preliminary prognosis of the tumors＆#39; risk and useful information for clinical treatment and follow-up.

关 键 词：直肠肿瘤 胃肠道间质瘤 体层摄影 X线计算机 

分 类 号：R73[医药卫生—肿瘤] R47[医药卫生—临床医学]