胃部原发性少见及罕见肿瘤的CT表现  

CT findings of rare primary tumors of the stomach

作　　者：叶宇 王珍 YE Yu;WANG Zhen(Department of Radiology,HuangShi Central Hospital of Edong Healthcare Group,Affiliated Hospital of Hubei Polytechnic University,Huangshi 435002,China)

机构地区：[1]湖北省鄂东医疗集团市中心医院放射影像科,湖北黄石435002

出　　处：《医学影像学杂志》2022年第12期2113-2116,共4页Journal of Medical Imaging

摘　　要：目的探讨分析胃部原发性少见及罕见肿瘤的CT表现。方法选取经病理证实8种类型胃部原发性少见及罕见肿瘤的CT表现,观察肿瘤发生部位、大小、病变范围(是否穿透浆膜层)、密度(囊变、钙化、坏死等)、黏膜完整性、CT强化方式及程度、壁外血管侵犯、周围淋巴结及邻近脏器侵犯。结果27例中原发性淋巴瘤13例,肝样腺癌5例,神经内分泌癌3例,神经鞘瘤2例,钙化性胃癌、尤文氏肉瘤、孤立性纤维瘤及血管球瘤各1例,淋巴瘤胃壁增厚伴胃腔扩张,肝样腺癌轻至中度强化,肝脏及淋巴结易转移伴甲胎蛋白增高,神经内分泌癌明显强化,神经鞘瘤边界清,腔外生长型肿块、呈渐进性强化,钙化性胃癌以胃壁钙化为主,尤文氏肉瘤病灶大,但壁外血管侵犯及淋巴结转移不显著,孤立性纤维瘤腔内生长型肿块、轻度均匀强化,血管球瘤强化峰值与腹主动脉相近。结论胃部少见及罕见肿瘤CT表现具有一定的特异性,仔细观察并结合临床实验室指标能提高其术前诊断准确性。Objective To investigate the CT findings of rare primary tumors of the stomach.Methods The imaging characteristics of 8 types of rare primary and gastric tumors confirmed by pathology were retrospectively analyzed.We have also evaluated the corresponding results of the patients,including the tumor position,size,scope of lesions(whether penetrating the serous membrane),density(cystic change,calcification,and necrosis),mucosal integrity,enhanced mode and degree,extramural vascular invasion,lymph node and adjacent organs metastasis.Results Among these 27 cases,there are 13 cases of gastric primary lymphoma,5 cases of hepatoid adenocarcinoma(HAS),3 cases of neuroendocrine cancer(NEC),2 cases of gastric schwannoma(GS),each one case of calcified gastric cancer,ewing sarcoma(ES),solitary fibrous tumor(SFT)and glomus tumor(GGT)respectively.According to the results,the cases of primary lymphoma all show diffuse gastric wall thicken and expansion,the cases of HAS all show mild or moderate homogeneous enhancement,also with liver and lymph node metastasis and increase of Alpha-fetoprotein.For NEC,there is obvious enhancement,but GS grows outside the cavity fields with clear margin and progressive uniform enhancement,and mottled calcification is observed in calcified gastric cancer.ES has big mass but extramural vascular invasion and lymph node is never observed,SFT grows inside the cavity fields with homogeneous enhancement.The peak CT value of enhancement about GGT is similar to that of the abdominal aorta.Conclusion The CT findings of rare primary tumors of the stomach are showing unique features.Its accuracy and careful observation can also be improved by methods of preoperative diagnosis with specific clinical laboratory indicators.

关 键 词：胃原发性肿瘤 少见 体层摄影术 X线计算机 

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