肠系膜胃肠道外间质瘤的增强CT特征

目的探讨肠系膜胃肠道外间质瘤（EGIST）的增强CT特征,以提高对该肿瘤的认识及诊断。方法回顾性分析经手术及病理证实的15例肠系膜EGIST患者的增强CT图像及临床资料。结果 15例肠系膜EGIST中,高度危险性11例,中度危险性4例,其中肝转移1例,腹腔种植转移1例。2例占据右中下腹盆腔,3例位于十二指肠降部周围,4例位于肠系膜根部,4例位于左下腹小肠系膜周围,2例位于盆腔右侧。肿瘤的最大直径为5.6-22.0 cm,平均约11.5 cm。类圆形6例,边界清晰;不规则、分叶状9例,边界模糊。15例密度不均,肿瘤内可见不同程度的囊变、坏死区,其中9例囊变、坏死范围超过50%;2例伴有钙化,1例...

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Published in影像诊断与介入放射学 Vol. 26; no. 4; pp. 277 - 281
Main Author 王灿 李雯 孙冰冰 杨春雪 陶晓峰
Format Journal Article
LanguageChinese
Published 上海交通大学医学院附属第九人民医院放射科,上海,201999 2017
Subjects
X线计算机
体层摄影术
肠系膜
胃肠道外间质瘤
肠系膜
胃肠道外间质瘤
Extragastrointestinal stromal tumor
Tomography
体层摄影术,X线计算机
Mesentery
X-ray computed
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ISSN1005-8001
DOI10.3969/j.issn.1005-8001.2017.04.003

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Summary:目的探讨肠系膜胃肠道外间质瘤（EGIST）的增强CT特征,以提高对该肿瘤的认识及诊断。方法回顾性分析经手术及病理证实的15例肠系膜EGIST患者的增强CT图像及临床资料。结果 15例肠系膜EGIST中,高度危险性11例,中度危险性4例,其中肝转移1例,腹腔种植转移1例。2例占据右中下腹盆腔,3例位于十二指肠降部周围,4例位于肠系膜根部,4例位于左下腹小肠系膜周围,2例位于盆腔右侧。肿瘤的最大直径为5.6-22.0 cm,平均约11.5 cm。类圆形6例,边界清晰;不规则、分叶状9例,边界模糊。15例密度不均,肿瘤内可见不同程度的囊变、坏死区,其中9例囊变、坏死范围超过50%;2例伴有钙化,1例伴有出血;增强扫描肿瘤实质部分轻至中度渐进性强化,动脉期增强幅度约22-32HU,静脉期增强幅度约38-40 HU,肿瘤囊变、坏死部分无强化。6例肿瘤实质内可见增粗扭曲条状、簇状肿瘤血管影,经MIP显示肿瘤均由肠系膜上动脉分支血管供血。结论肠系膜EGIST的增强CT图像有一定的特征性,特别是血管MIP成像对明确肿瘤供血来源及发病部位的诊断具有重要价值,有助于对该肿瘤的正确诊断以及术前评估。
Bibliography:Objective To review the CT features of extragastrointestinal stromal tumor（EGIST） in the mesentery. Methods The clinical records and CT of 15 patients with histologically confirmed EGIST in the mesentery were retrospectively studied. Results Of the 11 high-risk EGISTs and 4 intermediate-risk EGISTs, metastasis was observed in the liver（1）, abdominal cavity（1）, right lower abdomen and pelvis（2）, around the descending duodenum（3）, mesentery root（4）, left lower abdominal mesentery（4）, or right pelvis（2）. The mean tumor size was 11.5 cm（5.6-22.0 cm）. The tumor was round with well-defined boundary（6） or irregular with poor-de-fined boundary（9）. Unenhanced CT showed heterogeneous density with cystic-necrotic components in all 15 masses with calcification（2） or hemorrhage（1）. The solid components showed progressive mild to moderate enhancement with CT values of 22-32 HU in the ar-terial phase and 38-40 HU in the venous phase. The cystic-necrotic components did not enhance. Maximum intensity projection（MIP）helped to
ISSN:1005-8001
DOI:10.3969/j.issn.1005-8001.2017.04.003