胃肠道间叶组织源性肿瘤的超声诊断价值分析

Value of ultrasound in diagnosis of gastrointestinal mesenchymal tumors

目的探讨超声检查对胃肠道间叶组织源性肿瘤的诊断价值。方法25例经手术病理证实的胃肠道间叶组织源性肿瘤患者．其中男性9例，女性16例；年龄29～80岁．平均年龄57-2岁。回顾性分析其超声表现，并对超声诊断结果与病理诊断结果进行对比分析。结果间质瘤呈圆形或椭圆形，形态规整，边界清楚，内呈均匀低回声，血液运行不丰富；较大者形态不规整．内部回声不均并可见液性区，血液运行丰富。平滑肌瘤呈椭圆形或分叶状，形态规整，边界清楚，呈均匀低回声．肿瘤部位消化道壁结构完整。平滑肌肉瘤瘤体较大，形态不规整，边界不清楚，呈不均匀低回声；有坏死出血时声像图可见液性暗区。神经鞘瘤呈球状，形态规整，边界清楚，由黏膜下层向胃腔外生长，肿物部位黏膜连续完整。经手术病理确诊的25例胃肠道间叶组织源性肿瘤超声检出率为100％．定位诊断准确率为84％．超声定性诊断准确率为68％。结论超声检查对胃肠道间叶组织源性肿瘤的诊断有较大临床应用价值。

Objective To investigate the value of ultrasound in the diagnosis of gastrointestinal mesenchymal tumors. Methods A total of 25 patients with gastrointestinal mesenchymal tumors proved by operation and pathology were enrolled, included 9 males and 16 females, which were aged 29 - 80 years old with a mean age of 57.2. The ultrasonic features of them were analyzed and summarized, retrospectively; and the results of ultrasound diagnosis and pathological diagnosis were analyzed. Results Stromal tumors were round or oval with regular shape and clear boundary, the internal echo was even low echo, but without rich blood supply. The bigger stromal tumors had irregular shape, internal echo was low heterogeneous echo, with liquid region and rich blood supply. Leiomyoma were oval or lobulated with regular shape and clear boundary, the internal echo was homogeneous, and gastrointestinal wall was intact. Leiomyosarcoma tumors were larger with irregular shape and unclear boundary, internal echo was low heterogeneous echo, liquid dark area was visible when it had necrosis and hemorrhage. Schwannomas were spherical with regular shape and clear boundary, which grew from submucosa to gastric cavity, the mucosa of tumor site was continuous and complete. Twenty-five cases of gastrointestinal mesenchymal tumors were confirmed by operation and pathology, ultrasound detection rate was 100 %; the coincidence rate of localization was 84 % and diagnostic accuracy rate of ultrasound was 68 %. Conclusion It is demonstrated that ultrasound examination has important clinical values in the diagnosis of mesenchymal tumors.