胃血管球瘤的临床影像分析与鉴别诊断  

Clinical imaging analysis and differential diagnosis of gastric glomus tumor

作　　者：黄文鹏 李莉明[1] 韩懿静 赵慧萍[1] 王睿[1] 朱兵兵 高剑波[1] HUANG Wenpeng;LI Liming;HAN Yijing;ZHAO Huiping;WANG Rui;ZHU Bingbing;GAO Jianbo(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052

出　　处：《实用放射学杂志》2022年第7期1113-1117,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81971615)。

摘　　要：目的探讨胃血管球瘤(GGT)的临床病理特点、CT特征及鉴别诊断。方法回顾性收集并分析10例经病理组织学确诊的GGT患者的临床、病理及CT影像资料,并与胃间质瘤(GST)、异位胰腺(HP)的相关资料进行比较。结果10例GGT患者,临床表现为腹痛7例,合并腹胀1例、便血1例;恶心、嗳气1例;反酸、烧心1例;1例于体检时发现,从症状出现到确诊的时间0.5~15个月,中位时间为9个月。病灶位于胃体5例,胃窦5例,病灶最长径10~150 mm,平均(30.80±42.24)mm,病灶最厚径8~45 mm,平均(20.60±10.62)mm。9例CT表现为类圆形或圆形实性团块突向胃腔,边缘清晰、光滑,表面均无溃疡,周围均未见侵犯征象和增大淋巴结,1例表现为不规则肿块突破胃壁侵犯肝脏,边缘不清,内见坏死。增强后5例强化不均匀,5例强化均匀,其中6例出现中心充填样强化;6例呈渐进性强化,3例呈减退性强化,1例呈持续性强化;9例呈明显强化,1例呈中度强化。动脉期CT值与同层面腹主动脉CT值的比值平均为0.41±0.12,静脉期CT值与同层面腹主动脉CT值的比值平均为0.82±0.20。结论GGT好发于中老年女性,大部分为良性,CT表现多为胃窦部黏膜下单发软组织肿块,腔内型生长多见,黏膜多光整,增强多呈渐进性明显强化,增强双期病灶CT值与同层面腹主动脉CT值的比值较大。在胃黏膜下肿瘤的鉴别诊断中应考虑到GGT的可能性,确诊仍需组织病理学检查。Objective To explore the clinicopathological features,CT features and differential diagnosis of gastric glomus tumor(GGT).Methods The clinical,pathological and CT data of 10 patients with GGT diagnosed by histopathology were collected and analyzed retrospectively,and then compared with the related data of gastric stromal tumor(GST)and heterotopic pancreas(HP).Results 10 patients with GGT presented clinically with abdominal pain(7 cases),complicated by abdominal distension(1 case),hematochezia(1 case),nausea and belching(1 case),and acid reflux and heartburn(1 case).Additionally,1 case was found during physical examination.The median time from symptom onset to diagnosis was 9(range,0.5-15)months.The lesion locations were distributed in the gastric body in 5 cases and the gastric sinus in other 5 cases.The longest diameter and thickness of the lesion were(30.80±42.24)mm(range,10-150 mm)and(20.60±10.62)mm(range,845 mm),respectively.9 cases showed oval or round solid mass protruding into the gastric cavity with clear and smooth margin,without ulceration on the surface and invasion or enlarged lymph nodes in the surrounding area,while 1 case showed an irregular mass broke through the gastric wall and invaded the liver,with indistinct margin and internal necrosis.After contrast enhancement,5 cases showed heterogeneous enhancement and other 5 cases showed uniform enhancement,of which 6 cases showed central flling-like enhancement.The progressive enhancement in 6 cases,regressive enhancement in 3 cases and persistent enhancement in l case were showed,and the significant and moderate enhancement was seen in 9 and I case respectively.The mean ratio of CT values of the lesion to abdominal aorta at the same level in the arterial or venous phase was 0.41±0.12 or 0.82±0.20.Conclusion GGT occurs in middle-aged and elderly women,and most of them are benign.CT manifestations are mostly single soft tissue masses in the submucosa of the gastric sinus,with more common intracavitary growth type,smooth mucosa,mostly progressive an

关 键 词：胃 血管球瘤 计算机体层成像 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]