肠系膜间质瘤的CT征象与恶性危险度相关性研究

CT Features with Malignant Degree Correlation Study of Stromal Tumor in the Omentum and Mesentery

目的探讨肠系膜间质瘤的CT征象与恶性危险度相关性。方法回顾性分析经手术及病理证实的27例肠系膜间质瘤患者的CT表现，将肿瘤的大小、形态、密度、生长方式、界限、坏死囊变、钙化、强化方式与强化程度、远处转移等征象与肿瘤恶性危险度分级进行对照分析。结果27例肿瘤直径3．0～20．5cm，平均9．6cm；类圆形17例，不规则形10例；肿瘤与周围组织界限清楚14例，界限不清13例；肿瘤密度均匀11例，不均匀16例；低密度12例，等密度13例，高密度2例；肿瘤坏死囊变13例；肝脏转移3例，盆腔和肠系膜淋巴结转移9例，伴出血7例，少量腹腔积液12例。增强扫描均匀强化11例，不均匀强化16例；轻度强化7例，中度强化10例，明显强化10例，瘤内伴迂曲增粗异常血管8例。肿瘤高危险度8例，中危险度9例，低危险度7例，极低危险度3例。单变量分析结果显示：肿瘤大小、形态、生长方式、边缘情况、强化方式、坏死囊变、远处转移等差异有统计学意义（P〈0．05）。结论肠系膜间质瘤CT表现具有一定的特征性，肿瘤大小可用于预测肿瘤危险程度，对治疗和随访有指导意义。

Objective To investigate the correlation of CT characteristics with malignant degree of stromal tumors in the mesenteric. Methods The CT imaging of 27 cases with surgery and pathology proven stromal tumors in the mesenteric were retrospectively analyzed. Comparative study of the relationship between the size, form, density, growth mode, boundary, cystic necrosis, calcify, enhancement pattern and degree of enhancement, distant metastasis signs with classification of malig- nant tumor of risk. Results The tumor size of 3.0 ~ 20.5 era（the average 9.8 era）. 17 round, 10 irregular. 14 boundaries clear of tumor and surrounding tissue, 13 boundaries unclear of tumor and surrounding tissue. 11 homogeneous density, 16 inhomogeneous density. 12 low density, 13 density ,2 high density, 13 cystic and necrotic variable mass. 3 liver metastasis,9 pelvic and mesenteric lymph node metastasis ,7 with hemorrhage, 12 with ascites. Enhanced ： 11 homogeneous enhancement,16 inhomogeneous enhancement. 7 slight enhancement, 10 moderate enhancement, 10 marked enhancement,8 tumor with tortuous dilated vascular abnormalities. 3 very low risk,7 Low risk,9 moderate risk, 8 high risk. The malignant grade of MST had a significant correlation between size and splitting, no correlation with immunohistochemical phenotype;With the use of univariate analysis, the difference between size, morphology, growth pattern, edge cases, enhancement pattern, cystic necrosis and distant metastasis of tumor was statistical significance （ P 〈 0. 05 ）. Conclusion Certain characteristic CT findings could be assessed in omental and mesenteric stromal tumor, CT findings with pathologic correlation type and tissue compo- nents,may suggest the diagnosis of CT findings with clinical.