十二指肠间质瘤X线与CT影像诊断对照分析

X-ray and CT diagnostic control analysis of duodenal stromal tumor

目的对照分析十二指肠间质瘤X线钡餐造影与CT检查的影像表现,以提高对十二指肠间质瘤的诊断水平。方法回顾11例十二指肠间质瘤患者临床资料、X线造影及CT影像表现,并经病理及免疫组织化学法证实。结果 11例患者中7例位于十二指肠降部(63.6%),3例位于十二指肠水平部(27.3%),1例位于十二指肠球部(9.1%)。X线钡餐造影表现11例患者中十二指肠不同程度狭窄9例;局部充盈缺损或龛影、黏膜变平或破坏、消失11例;2例形成窦道样改变。CT表现,平扫:11例患者中有7例表现为均匀软组织密度,4例表现为不均匀软组织密度,其内可见液化坏死;增强扫描:动脉期、静脉期病灶实性部分强化,静脉期强化明显,液化坏死部分无强化,6例与周围组织分界清晰,5例与周围组织分界不清。结论 X线与CT检查都可以发现十二指肠间质瘤,二者互为补充,可提高十二指肠间质瘤判断正确率,为临床进一步诊治提供帮助。

Objective The aim of this study was to compare the performance of duodenal gastrointestinal stroreal tumors （GIST） on X-ray barium meal contrast examination with computed tomography （CT）, in order to improve the diagnostic level of duodenal GIST. Methods The clinical data, imaging findings on X-ray barium meal contrast examination and CT, were analyzed in 11 cases of duodenal GIST patients, who had been confirmed by pathologic and immunohistochemical examination. Results In the 11 duodenal GIST patients, 7 cases had tumors in descending part of duodenum （63.6%）; 3 eases had tumors in horizontal part of duodenum （27.3%） and 1 case in duodenal bulb （9.1%）. X-ray barium meal eontrast examination demonstrated that in the 11 patients, 9 eases had different degree of duodenum stenosis; 11 cases manifested as local filling defect or niche, with mueosa flattening, destroyed and disap- pearing; 2 eases had fistula in the tumors. CT plain scan showed that 7 eases of patients demonstrated with homoge- neous soft tissue density mass in duodenum and 4 cases with inhomogenous soft tissue density mass with liquefaction neerosis in the tumors. CT enhancement scan showed that the entity part of lesions both enhanced in arterial phase and venous phase, especially in the venous phase, and there was no enhancement in the liquefaction neerosis parts. Six patients had clear tumor boundaries with surrounding tissue and 5 patients had unclear boundaries. Conclusion X-ray and CT can both detect duodenal GIST. The two imaging methods could complement each to improve the judgments accuracy of duodenal GIST and even to supply further help on clinieal diagnosis and treatment.