原发性十二指肠间质瘤多层螺旋CT强化表现与病理危险度的相关分析  

Correlation between MSCT features and pathological risk in primary duodenal stromal tumor

作　　者：吴文秀 吴梦楠[2] 潘爱珍 徐志锋 WU Wenxiu;WU Mengnan;PAN Aizhen;XU Zhifeng(Department of Radiology,the First People's Hospital of Foshan(Foshan Hospital Affiliated to Sun Yat-sen University),Foshan 528000,China;Department of Radiology,Heyuan Hospital Affiliated to Jinan University,Heyuan 517000,China)

机构地区：[1]佛山市第一人民医院(中山大学附属佛山医院)影像科,广东佛山528000 [2]暨南大学附属河源医院放射科,广东河源517000

出　　处：《分子影像学杂志》2020年第3期410-414,共5页Journal of Molecular Imaging

摘　　要：目的分析不同病理危险度的原发性十二指肠间质瘤(PDST)的多层螺旋CT(MSCT)强化表现,以提高PDST的术前不同危险度分级诊断率。方法回顾性分析20例经手术病理证实的原发性十二指肠间质瘤的临床及影像资料,包括肿瘤的部位、形态、大小、密度、边界、增强扫描动脉期、静脉期及延迟期特点及多层面重建,依据病理分级分为低危组和高危2组,进行上述征象的秩和检验。结果 20例PDST中,位于球部3例,降部11例,水平部6例;病变呈囊实性8例,实性12例;病变向腔内生长1例,腔内外生长8例,腔外生长11例。3例极低危险度,9例低危险度,0例中度危险度,8例高度危险度。增强动脉期明显均匀或不均匀强化,13例呈血管样强化,病变越大,强化越不均匀。8例为高危组,大小5.06±1.64 cm;12例为低危组,大小2.83±1.79cm。低危组的大小、静脉期差值与高危组的差异具有统计学意义(P<0.05)。结论 MSCT增强及多层面重建有利于诊断PDST,肿瘤大小及静脉期差值能有效评估原发性PDST危险度分级,低危组与高危组间质瘤在临床特征与CT强化表现上存在差异。Objective To improve the preoperative diagnosis rate of Primary duodenal stromal tumor(PDST) by analyzing the MSCT enhancement of PDST with different pathological risks. Methods The clinical and imaging data of 20 cases confirmed by surgery pathology of primary duodenal stromal tumor were retrospectivly analyzed. The tumor location, shape, size,density, boundary, enhanced scan, arterial and venous phase and delay characteristic were observed. According to the pathological grading into low-risk and high-risk group, the signs of rank and inspection were analyzed. Results Three of the 20 cases with PDST were located in the bulb, 11 cases were descending, and 6 cases were horizontal.The lesions were solid-cystic in 8 cases and solid in 12 cases.The lesions grew into the lumen in 1 case, inside and outside the lumen in 8 cases,and outside the lumen in 11 cases.There were 3 cases of very low risk, 9 cases of low risk, 0 cases of moderate risk, and 8 cases of high risk. At the enhancement stage, the enhancement was obviously uniform or non-uniform, 13 cases presented vascular enhancement, the bigger the lesion and the more non-uniform the enhancement. Eight were in the high-risk group with an average size of 5.06 ± 1.64 cm. 12 were in the low-risk group with an average size of 2.83 ± 1.79 cm. The size and venous difference of the low-risk group were significantly differrent from the high-risk group(P<0.05). Conclusion MSCT enhancement and multilevel reconstruction are conducive to the diagnosis of PDST. Tumor size and venous phase difference can effectively evaluate the primary PDST risk grading. The clinical characteristics and CT enhancement of the low-risk group and high-risk group of interstitial tumors are different.

关 键 词：十二指肠 间质瘤 病理危险度 多层螺旋CT 

分 类 号：R735.31[医药卫生—肿瘤] R730.44[医药卫生—临床医学]