小肠间质瘤的影像学诊断及其临床应用

目的：探讨小肠间质肿瘤的影像学诊断及其临床应用价值。方法选取平煤神马医疗集团总医院自1995年1月～2005年12月收治的25例小肠间质瘤患者，所有患者均行小肠导管法气钡双对比造影检查，其中13例加作口服钡餐追踪造影检查，5例加作行CT检查，6例加作DSA检查，对影像学检查的综合表现特点进行分析。结果25例小肠间质肿瘤中，发病部位位于十二指肠9例，占36.00%，良性间质肿瘤6例，恶性间质肿瘤3例；位于空肠12例，占40.00%,良性间质肿瘤3例，恶性间质肿瘤9例；位于回肠4例，占16.00%,良性间质肿瘤2例，恶性间质肿瘤2例。小肠导管法气钡双对比造影检查及口服钡餐追踪造影检查表现为病变区肠管内充盈缺损，伴中央钡斑形成；肠腔偏心性狭窄；黏膜皱襞平坦或破坏、消失。CT表现为肠腔内、外不规则肿块，可有“分叶”改变；肿块与周围组织分界不清，可有粘连；肿块内出现多灶性低密度坏死区，增强扫描可见不均匀强化。DSA显示动脉血管增粗扩张，静脉回流早显；肿瘤血管边界清楚。结论小肠导管法气钡双对比造影检查联合CT、DSA检查,是本病定位及定性诊断的主要和可靠方法，是临床治疗较准确的依据。

Objective To investigate the experience in the imageological diagnosis and the value of clinical application for small intestine interstitialoma. Methods The imageological comprehensive manifestation of twenty-ifve patients （pats） with small intestine interstitialoma proved surgically and pathologically at the institution from Jan 1995 to Dec 2005 were retrospective analyzed. Overall patients underwent small intestine air-barium enema double-contrast examination （Intubation）. In addition, barium meal stepping examination was performed in 13 pats, MSCT performed in 5 pats and Digital Subtraction Angiography （DSA） performed in 6 pats. Results In this group 9 pats （36.00%, 6 were benign tumors and 3 were malignant） occurred in the duodenum, 12 pats （48.00%, 3 were benign tumors and 9 were malignant） in jejunum, 4 pats （16.00%, 2 were benign and 3 were malignant） in ileum. The ifndings in small intestine air-barium enema double-contrast examination and barium meal stepping examination concluded partial iflling defect with center barium lfeck within the lesion, eccentric luminal stenosis, and lfattened or destroyed mucosal folds. An extralumial and intraluminal irregular or lobulated mass was dentiifed in MSCT examination. And the mass was ill-deifned borers and immovable. Some small intestine interstitialoma appeared mulifocal hypodense necrosis, and inhomogeneous enhancement in contrasr enhanced MSCT examination. The DSA revealed artery enlarged and tortuous, contrast medium stain of the mass lesion （tumor stain） in the late arterial phase and capillary phase, and early visualization of draining vein. Conclusion The comprehensive application of small intestine air-barium enema double-contrast examination combined with MSCT and DSA were of the main and reliable methods in the niveau diagnosis and qualitative diagnosis of small intestine interstitialoma, and were of the precise and favourable foundation for clinical treatment.