小肠间质瘤MSCT表现与病理危险度相关分析  

A study on the correlation between MSCT findings and pathological risk of small intestinal stromal tumor

作　　者：蔡培坤[1] 陈杰彬[1] 董琴[1] 梁焕[1] 梁晖辉[1] 黄其文[1] 侯舒倩 CAI Peikun;CHEN Jiebin;DONG Qin;LIANG Huan;LIANG Huihui;HUANG Qiwen;HOU Shuqian(Department of CT,the Maoming People’s Hospital,Maoming 525000,China)

机构地区：[1]广东省茂名市人民医院CT科,茂名525000

出　　处：《功能与分子医学影像学（电子版）》2020年第3期1875-1881,共7页Functional and Molecular Medical Imaging(Electronic Edition)

摘　　要：目的分析不同病理危险度的小肠间质瘤多层螺旋CT(MSCT)影像表现,与病理危险度进行对照分析,提高原发性小肠间质瘤的术前诊断率及危险度评估。方法回顾性分析45例经手术病理证实的原发性小肠间质瘤的临床及影像资料,包括患者的年龄、肿瘤的发生部位、形态、大小、囊实性、生长方式、平扫、增强扫描动脉期、静脉期及延迟期特点,依据病理分级分为极低危/低危组和中危/高危2组,进行卡方检验及单因素方差分析,以P<0.05为差异具有统计学意义。结果45例小肠间质瘤中,肿瘤位于十二指肠20例,空肠12例,回肠13例。肿瘤大小位于1.2~15.3 cm,其中,<5 cm为22例,介于5~10 cm为19例,≥10 cm为4例。实性18例,囊实性27例,其中8例见积气。病变向腔内生长6例,腔内外生长14例,腔外生长25例。极低危险度4例,低危险度13例,中危险度3例,高危险度25例。小肠间质瘤增强扫描动脉期血管样强化,高危险组到达峰值时间长,且峰值要低于低危险组。肿瘤的发生部位、大小、囊实性、增强静脉期及延迟期在极低/低危组和中危/高危组间差异有统计学意义(P<0.05)。结论肿瘤囊实性、积气、MSCT增强及多层面重建有利于诊断小肠间质瘤,肿瘤大小、囊变、增强静脉期及延迟期能有效评估原发性小肠间质瘤危险度分级,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,可为临床术前提供分级参考。Objective To improve the preoperative diagnosis accuracy of small intestinal stromal tumor and risk assessment by analyzing the enhancement in the MSCT for patients with different pathological risks.Methods 45 cases of surgically confirmed primary small intestinal stromal tumor were retrospectively collected and the clinical and imaging data,including age,location,shape,size of tumor,pouch or solid,growth way,scan and enhanced scan,arterial and venous phase and delay characteristic were divided into 2 groups based on the pathological grading:very low risk/low risk group and moderate/high risk group.Then chi-square test and single factor variance analysis were performed with P<0.05 for statistically difference.Results Among the 45 cases of small intestinal stromal tumors,the tumors were located in the duodenum in 20 cases,jejunum in 12 cases and ileum in 13 cases.The tumor size ranged from 1.2 cm to 15.3 cm,with 22 cases<5 cm,19 cases between 5 and 10 cm,and 4 cases≥10 cm.There were 18 solid cases and 27 cysts solid cases,among which 8 cases showed gas accumulation.There were 6 cases of lesions growing into lumen,14 cases of lesions growing across the wall and 25 cases of lesions growing out of lumen.There were 4 cases of very low risk,13 cases of low risk,3 cases of medium risk,and 25 cases of high risk.Contrast-enhanced scan of small intestinal stromal tumors revealed arterial angiogenic enhancement,with a longer peak time and a lower peak in the high-risk group comparing with the low-risk group.There were statistically significant differences in tumor location,size,cystic firmness,enhanced venous phase and delayed phase between the very low/low risk group and the medium/high risk group(P<0.05).Conclusions MSCT enhanced and multidimensional reconstruction is helpful for diagnosis of small intestinal stromal tumor.Tumor size,cystic change,enhance venous phase and delayed phase can beused to effectively assess the risk of primary small intestinal stromal tumor classification as low risk and high risk stromal tum

关 键 词：小肠 间质瘤 病理危险度 多层螺旋CT 

分 类 号：R445.3[医药卫生—影像医学与核医学] R735.3[医药卫生—诊断学]