机构地区:[1]青岛大学附属泰安市中心医院医学影像中心,泰安271000
出 处:《中华解剖与临床杂志》2024年第10期650-654,共5页Chinese Journal of Anatomy and Clinics
摘 要:目的探讨胃神经鞘瘤(GS)及胃周反应性增生淋巴结的CT平扫及增强扫描影像特点。方法横断面研究。纳入青岛大学附属泰安市中心医院经手术病理确诊的GS患者30例, 其中男12例、女18例, 年龄33~85(57.5±10.4)岁。27例患者行腹部CT平扫及增强扫描、3例增强扫描。收集患者CT平扫及增强资料, 观察GS及胃周反应性增生淋巴结CT平扫及增强扫描特点。结果 (1)30例患者CT平扫示GS均为单发, 肿瘤边缘清晰, 发生于胃体21例、胃底4例、胃窦5例, 3例突向腔内、3例突向腔外、24例突向腔内外, 瘤体呈圆形14例、椭圆形10例、分叶状6例;9例表面有溃疡, 其中脐凹状4例、小溃疡3例、裂隙状溃疡2例;3例瘤体多发点状钙化灶;1例瘤体远侧低密度坏死区。27例患者CT平扫病灶均呈等密度或稍低密度;30例患者增强扫描结果示肿瘤均呈渐进性强化, 峰值均在延迟期, 其中7例中度强化、23例明显强化, 最大强化率0.79~3.09(1.61±0.63)。GS在平扫、增强扫描动脉期的CT值与正常胃壁相比均无明显变化, 差异均无统计学意义(P值均>0.05);在CT增强扫描静脉期及延迟期的CT值分别为(68.27±12.34)、(82.47±12.81)Hu, 高于正常胃壁的(55.90±9.39)、(59.57±10.12)Hu, 差异均有统计学意义(t=4.37、7.67, P值均<0.001)。(2)30例患者中15例患者胃周见26枚稍大淋巴结, CT平扫为均匀等密度影, 长径6~17(10.8±2.8)mm, 短径6~9(7.1±1.0)mm;位于胃小弯侧13枚、胃大弯侧8枚、胃网膜淋巴结4枚、腹腔干淋巴结1枚;18枚形状为长圆形或哑铃形、8枚为类圆形, 边缘均较清晰。其余15例患者, 因淋巴结过小或未显示而未纳入评估。CT增强扫描示6枚淋巴结中度强化, 20枚淋巴结明显强化, 最大强化率1.16~3.29(2.03±0.73);平扫及增强扫描动脉期、静脉期、延迟期CT值分别为(30.44±5.05)、(69.35±11.45)、(90.23±19.43)、(68.35±10.87)Hu, 强化峰值均在静脉期。结论 GS的CT影像Objective This study aimed to explore the CT scan and the enhanced scanning features of gastric Schwannoma(GS)and its surrounding reactive hyperplasia lymph nodes.Methods A cross-sectional study was performed on 30 patients with GS(12 males and 18 females aged 33-85(57.5±10.4)who were admitted to Tai'an Central Hospital affiliated to Qingdao University.Surgical pathology was examined,immunohistochemical staining was performed.All patients with GS were single.Twenty seven patients underwent abdominal CT plain scan and enhanced scan,and 3 patients underwent enhanced scan.CT plain scan and enhanced scan data were collected.The clinical features of GS,plain CT scan,and the enhanced features of GS and perigastric reactive hyperplasia lymph nodes were investigated.Results(1)CT plain scan showed that all the tumors with clear margins occurred in the stomach body in 21 cases,fundus in 4 cases,and antrum in 5 cases.Moreover,3 cases were intraluminal;3,extraluminal;and 24,intraluminal.The tumors were round in 14 cases,oval in 10,and lobulated in 6.Nine cases had surface ulcers,including 4 umbilical pits,3 small ulcers,and 2 fissured ulcers.Multiple punctate calcification foci were observed in three cases,and distal low-density necrotic area of tumor was found in one case.Plain CT scan results showed that all tumors presented equal density or slightly low density,and enhanced scan results showed that all tumors presented progressive enhancement,the peak value was in the delayed stage,seven patients had moderate enhancement,23 patients had obvious enhancement,and the maximum enhancement rate was 0.79-3.09(1.61±0.63)Hu.The CT values of GS in plain CT scan and arterial stage of enhanced scan had no significant changes compared with normal gastric walls,and the differences were not statistically significant(all P values>0.05).The CT values of GS in the venous and delayed phases of the enhanced CT scan were(68.27±12.34)and(82.47±12.81)Hu,respectively,which were higher than the CT value of the normal gastric wall([55.90±9.39
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...