20例胃平滑肌肿瘤的病理—X线分析

The Pathological-Radiological Analysis of 20 Cases Leiomyomatous Neoplasms of Stomach

为了提高对胃平滑肌肿瘤的认识,作者回顾性分析了20例经手术、病理证实的胃平滑肌肿瘤的钡餐造影所见。结果表明,胃底与胃体上部是胃平滑肌肿瘤的病变高发区。本病具有典型胃粘膜下肿瘤的X线特征,腔内型者可见胃内边缘光滑的充盈缺损或软组织肿块,粘膜展平或推移;腔外型者可见突出胃外肿块或/和胃与邻近脏器受压;腔内外型者具有上述双重特征,肿瘤较大者多有溃疡形成,甚至囊变,根据肿瘤的大小、形态、生长类型及溃疡表现可作良恶性鉴别。本病的术前诊断主要依靠X线钡餐检查,但无胃肠压迫的腔外型肿瘤,钡餐则难以发现,CT或选择性血管造影可助诊断。

The X-ray appearances shown in barium gastrointestinal examination of 20 cases leiomyomatous neoplasms of stomach proved surgically and pathologically were analysed retrospectively for diagnosis elevating. The results showed that most leiomyomatous neoplasms of stomach developed in fundus and the upper part of body. The disease had the typical radiological characteristic of submucosal gastric neoplasm. The X-ray findings of the inner-lumen type were the smooth margin filling defect within the stomach, soft tissue mass, flattened and compressed mucosal fold. Mass projecting out of the lumen or/and compression to the stomach and adjacent organs could be found in outer-lumen type. And in inner-outer lumen type characteristic findings of both outer type and inner -type could be found. Ulceration, even cystic change, developed in most larger lessions. Differentiation between benign and malignant tumor could be reached according to their size, shape, developing way and ulceration. The pre -operation diagnosis to gastric leiomyomatous neoplasm chiefly depend on barium meal study. CT or selective angiography could help to diagnoses the outer-lumen type one which caused no compression on gastrointestinal tract and was difficultly found out by barium meal.