“起源胃壁强化征”辅助CT诊断胃外生型胃肠间质瘤  

The sign of origination stomach wall hyper-enhancement facilitates the diagnosis of exogenic gastrointestinal stromal tumor

作　　者：付佳[1,4] 唐磊 李健[2] 李子禹 李英[1] 李晓婷[1] 孙应实[1] 沈琳[2] Fu Jia;Tang Lei;Li Jian;Li Ziyu;Li Ying;Li Xiaoting;Sun Yingshi;Shen Lin(Department of Radiology,Peking University Cancer Hospital & Institute,Key laboratory of Carcinogenesis and Translational Research,Beijing 100142,China;Department of Gastroenterology,Peking University Cancer Hospital & Institute,Key laboratory of Carcinogenesis and Translational Research,Beijing 100142,China;Department of Gastrointestinal Cancer Center,Peking University Cancer Hospital & Institute,Key laboratory of Carcinogenesis and Translational Research,Beijing 100142,China;Department of Radiology,Civil Aviation General Hospital,Beijing 100123,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所,恶性肿瘤发病机制及转化研究教育部重点实验室医学影像科 [2]北京大学肿瘤医院消化内科 [3]北京大学肿瘤医院胃肠肿瘤中心 [4]北京民航总医院放射科

出　　处：《中华结直肠疾病电子杂志》2019年第3期231-235,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：首都临床特色应用研究与成果推广(No.Z161100000516060);北京市医管局青苗计划(No.QML20161102);国家自然科学基金(No.81371715)

摘　　要：目的探讨肿瘤起源胃壁强化特征及坏死囊变成分的极性分布情况在胃外生型胃肠间质瘤(GIST)鉴别诊断中的意义。方法回顾分析经手术病理证实的胃外生型(Ⅲ型)GIST病例18例,对照组设置与胃壁脂肪间隙消失的邻近脏器起源肿瘤16例(胰腺神经内分泌肿瘤6例,胰腺实性假乳头状瘤8例,肝癌2例),观察记录与肿瘤贴邻的胃壁是否存在CT"起源胃壁强化征"及"坏死囊变极性"分布的情况。同时测量肿瘤长径及动静脉期CT值。结果GIST肿块相邻胃壁局限高强化比例(9/15)高于其他脏器来源肿瘤(0/16),差异具有统计学意义(χ^2=12.857,P=0.007)。肿瘤坏死囊变极性分布情况,GIST较其他脏器来源肿瘤更多偏离胃壁侧分布,但差异无统计学意义(χ^2=5.947,P=0.051)。两组肿瘤的长径(Z=-0.587,P=0.570)、动脉期(Z=-0.829,P=0.412)及静脉期平均CT值(Z=-1.450,P=0.147)差异均无统计学意义。结论起源胃壁强化征可辅助CT鉴别诊断胃外生型胃肠间质瘤。Objective To explore the significance of the origination stomach wall hyper-enhancement sign and the polar distribution of necrosis and cyst component in differential diagnosis of exogenic gastrointestinal stromal tumor (GIST). Methods CT images of pathologically proven typeⅢ GIST (n=18) and other tumors from adjacent organ (pancreatic neuroendocrine tumor, n=6;SPT, n=8;HCC, n=2) with fat space disappeared between stomach wall and the tumors were analyzed prospectively. The status of the origination stomach wall hyper-enhancement sign and the polar distribution of necrosis and cyst component were recorded. The longest diameters and CT values (HU) on arterial and venous phases were measured. Results The ratio of origination stomach wall hyper-enhancement sign in GIST (9/15) was higher than other organ originated tumors (0/16)(χ^2=12.857, P=0.007). On the polar distribution of necrosis and cyst component, the necrosis and cyst component of GIST was more prone to deviate away from gastric wall than the other organ originated tumors, but without statistical significance (χ^2=5.947, P=0.051). There was no significance demonstrated in longest diameters (Z=-0.587, P=0.570) and CT values of both arterial (Z=-0.829, P=0.412) and venous phases (Z=-1.450, P=0.147). Conclusion The origination stomach wall hyper-enhancement sign can facilitate CT in differential diagnosis of gastric exogenic gastrointestinal stromal tumor.

关 键 词：胃肠间质瘤 计算机体层摄影 X线 诊断 

分 类 号：R735[医药卫生—肿瘤]