胃肠道间质瘤的超声征象与病理危险度相关性分析

Correlation of Ultrasound Imaging Features and Risk Classification of Gastrointestinal Stromal Tumors

目的探讨胃肠道间质瘤（GIST）的超声征象与病理危险度的相关性。方法回顾性分析48例经病理及免疫组化证实的原发性GIST的术前超声图像，对病灶的超声表现与病变不同危险度之间进行对照分析。结果本组48例胃肠道间质瘤患者均为单发。肿瘤位于胃部32例，小肠11例，结肠5例。极低危险组12例，低危险组16例，中危险组11例，高危险组9例。极低及低危险度者直径为0．6～5．6cm；中危险度者直径为3．6～4．1cm；高危险度者直径为2．8～10．8cm。GIST的高、中、低及极低危险度与肿块直径、内部回声是否均匀、是否有钙化及坏死液化和是否有转移方面差异有统计学意义（P〈0．05），而与肿块形态是否规则、生长方式、血流信号有无方面比较，差异无统计学意义（P〉0．05），肿瘤位置与内镜和术中所见符合45例（93．8％）。结论胃肠道间质瘤的超声特征对评估GIST的危险性有重要价值，较大肿块、内回声不均匀、合并有钙化、坏死液化和转移提示为高度危险性GIST。

Objective To evaluate the correlation of the gastrointestinal stromal tumor（GIST） ultrasound（US） feature and the risk classification. Methods the US imageing data of 48 cases of primary GIST confirmed by pathology were retrospectively studied and com- pared with different risk of pathologic findings by analyzing the US manifestations of GIST. Results All GIST cases were single lesion. In the total 48 patients,32 originated from stomach, 11 from small intestine,5 from colon. 12 patients belonged to very low risk group, 16 to low risk, 11 to moderate risk,9 to high risk. In very low and low risk groups,tumor diameter was 0.6 -5.6cm;in moderate risk,tumor di- ameter 3.6 -4. l cm ;in high risk,tumor diameter 2.8 -10.8cm. There was statistical difference between the tumor size,internal echo lev- el, calcification, liquefied necrosis area, metastasis and the risk classification （P 〈 0.05 ）. There was no statistical difference between the lo- cation of tumor, feature of tumor morphology, grow pattern, blood flow distribution and the risk classification（ P 〉 0.05 ）. The location accu- racy rate of GIST was 93.8%. Conclusion The US feature of GIST has predictive value with respect to GIST risk classification. GIST with larger size, heterogeneous internal echo, calcification,liquefied necrosis area, metastasis are prompting high risk lesions.