原发性消化道恶性黑色素瘤的影像表现  

The imaging findings of primary malignant melanoma of digestive tract

作　　者：陈妙玲[1] 郑晓林[1] 邹玉坚[1] 梁满球[1] 黄翔[1] 高敏[2] CHEN Miao-ling;ZHENG Xiao-lin;ZOU Yu-jian(Department of Radiology,Dongguan People's Hospital,Guangdong 523000,China)

机构地区：[1]东莞市人民医院放射科,广东523000 [2]东莞市人民医院病理科,广东523000

出　　处：《放射学实践》2021年第9期1116-1121,共6页Radiologic Practice

摘　　要：目的:探讨原发性消化道恶性黑色素瘤(PMDT)的影像学表现。方法:回顾性分析10例经组织病理学证实的PMDT患者的影像及临床资料。结果:10例PMDT患者中6例影像表现为蕈伞型肿块充满管腔,4例表现为管壁明显增厚,均沿肠管纵轴生长,大于2.0 cm,局部扩大管腔,但多无消化道梗阻;肿瘤T 1WI呈稍高信号,T 2WI多呈高低混杂信号;密度均匀,无钙化及囊变坏死;增强扫描动脉期肿瘤多呈中度强化,静脉期呈进行性强化,其中7例周围见增粗血管;PET/CT示肿瘤18 F-FDG摄取明显。6例肿瘤浸润周围脂肪,7例可见周围多发淋巴结。结论:原发性消化道恶性黑色素瘤的CT和MRI表现具有一定特征性,肿瘤较大却多无梗阻、质地均质、T1驰豫时间缩短、较明显强化并持续性强化、高代谢水平对诊断具有一定价值。Objective:To evaluate the imaging features of primary malignant melanoma of digestive tract(PMDT).Methods:The imaging and clinical data of 10 cases of PMDT confirmed by histopathology were analyzed retrospectively.Results:Among the ten cases of PMDT,six of them manifested as bulky intraluminal fungating masse,while four of them showed wall thickening without a distinct mass,which seemed to have a tendency to grow along the longitudinal axis of the bowel.All of them were larger than 2.0cm that may focally expand the lumen without causing obstruction.The tumors showed hyperintense signal on T 1WI and mixed signal intensity on T 2WI.Homogenous density of tumors was observed in CT with no calcification and cystic necrosis.Lesions showed moderate enhancement in the arterial phase and progressive enhancement in the venous phase.7 cases had thick blood vessels around the tumor.Tumors were typically FDG avid on 18 F-FDG PET/CT.6 cases had peripheral fat infiltration and multiple lymph nodes were found in 7 patients.Conclusion:The CT and MRI manifestations of PMDT show some characteristics.Larger tumor without obstruction,homogenous density,T 1 hyperintensity,hyperenhancement,persistent enhancement and hypermetabolism are important signs for PMDT diagnosis.

关 键 词：黑色素瘤 消化道 磁共振成像 体层摄影术 X线计算机 正电子发射计算机断层扫描 

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