胃神经鞘瘤与胃间质瘤多排CT特征及误诊分析  

Multi-slice CT Features and Misdiagnosis Analysis of Gastric Schwannoma and Gastric Stromal Tumor

作　　者：黄科峰 周怡 金文义 宋君 方晓熠 邓辉 王燕 HUANG Ke-feng;ZHOU Yi;JIN Wen-yi;SONG Jun;FANG Xiao-yi;DENG Hui;WANG Yan(Radiological Diagnosis Department of the 991st Hospital of the Joint Logistics Support Force,Xiangyang 441003,Hubei Province,China)

机构地区：[1]联勤保障部队第九九一医院放射诊断科,湖北襄阳441003

出　　处：《中国CT和MRI杂志》2024年第8期106-107,共2页Chinese Journal of CT and MRI

摘　　要：目的探讨10cm以下的胃神经鞘瘤与胃间质瘤的多排CT特征,分析其误诊原因。方法回顾性分析本院近3年经手术病理证实的6例胃神经鞘瘤和15例胃间质瘤的完整临床、影像学资料,分析二者的多排CT特征。结果6例胃神经鞘瘤,5例误诊为胃间质瘤,6例神经鞘瘤和15例胃间质瘤均为单发肿块,均位于胃体部,前者形态规则呈类圆形,密度均匀,边界清晰,周围脂肪间隙无浸润。后者密度不均,形态不规则呈分叶状,部分病灶周围脂肪间隙欠清晰。二者均以向腔内生长为多。动态增强前者呈中度均匀渐进性强化,后者为动脉期强化,门静脉期强化最明显,平衡期减退,病灶内低密度区不强化或轻度强化。前者周围可见小淋巴结影,后者可见肿大淋巴结影,二者均未见远处转移。结论10cm以下胃神经鞘瘤与胃间质瘤在形态、边界、囊变、密度,强化方式,周围脂肪间隙及淋巴结情况有一定的特征,具有鉴别诊断意义,但肿瘤较小时,影像学鉴别较难。Objective To explore the multi-slice CT features of gastric schwannoma and gastric stromal tumors(dia<10cm)and analyze the causes of misdiagnosis.Methods A retrospective analysis was conducted on the complete clinical and imaging data of 6 cases of gastric schwannoma and 15 cases of gastric stromal tumors confirmed by surgery and pathology and the multi-slice CT features in our hospital in the past 3 years.Results 5 of 6 cases of gastric schwannoma were misdiagnosed as gastric stromal tumors,6 cases of schwannoma and 15 cases of gastric stromal tumors were all solitary and located in the body of the stomach.The 6 cases of schwannoma had a regular round shape,uniform density,clear boundaries,and no infiltration in the surrounding fat spaces.The 15 cases of gastric stromal tumors had uneven density and irregular lobulated morphology,and some lesions had unclear fat spaces.Both analyses more tend to grow inward.The dynamic enhancement of the 6 cases of schwannoma showed moderate uniform progressive enhancement,while the 15 cases of gastric stromal tumors showed arterial phase enhancement,portal vein phase enhancement was the most obvious,balance phase reduction,and low-density areas within the lesion were not enhanced or slightly enhanced.Small lymph node shadows can be seen around the 6 cases of schwannoma,while swollen lymph node shadows can be seen in the 15 cases of gastric stromal tumors.Both analyses have no distant metastasis.Conclusion Gastric schwannoma and gastric stromal tumors(dia<10cm)have certain characteristics in morphology,boundary,cystic changes,density,enhancement mode,surrounding fat spaces,and lymph node conditions,which have differential diagnostic significance.However,when tumor is small,the imaging differentiation is difficult to distinguish.

关 键 词：胃肿瘤 神经鞘瘤 间质瘤 X线计算机 体层摄影术 

分 类 号：R735.2[医药卫生—肿瘤]