超声检查对小肠间质瘤的诊断价值

Diagnostic value of small bowel stromal tumors with ultrasonography

目的探讨超声检查对小肠间质瘤的临床诊断价值。方法对福建省肿瘤医院2008年4月至2015年5月收治且经手术及病理证实的39例小肠间质瘤患者的超声资料进行回顾性分析。结果按病理危险分级标准将39例患者分为极低危组（1例）、低危组（11例）、中等危组（1例）、高危组（26例）。超声诊断符合率为64.1%（25/39）,漏诊2例（5.1%）。低危组病灶超声表现均呈边界清楚的低回声团块,多呈类圆形,内部回声均匀,团块内部多见Ⅰ级血流信号（63.6%,7/11）;高危组病灶呈囊实性和低回声,团块多数边界清楚,但内部回声不均,46.2%呈分叶状,团块内部多见Ⅱ~Ⅲ级血流信号（61.5%,16/26）。结论超声作为临床应用最广的检查项目之一,对小肠间质瘤的术前筛查具有重要价值,结合临床表现有助于提高其诊断率。

Objective To investigate the clinical value of ultrasonography（ US） in diagnosing small bowel stromal tumors（ SBST）. Methods 39 SBST patients pathologically confirmed from April 2008 to May 2015 in our hospital were evaluated retrospectively. Results 39 patients were divided into very low-risk group（ n = 1）,low-risk group（ n = 11）,moderate-risk group（ n = 1）,and high-risk group（ n = 26） based on the risk of malignancy. The coincidence rate of US was 64. 1%（ 25 /39）. Only 2 cases were misdiagnosed（ 5. 1%,2 /39）. The ultrasonic images in the low-risk group（ n = 11） showed that the masses were like-round,with even low echo and clear boundary,and the I visible class blood flow signals were detected in the masses of 7 cases in this group（ 63. 6%,7 /11）. The ultrasonic images in the high-risk group（ n = 26） showed cystic and solid masses with uneven low echo and clear boundary,and the masses of 12 cases in this group（ 46. 2%,12 /26） were lobulated,and the Ⅱ ~ Ⅲ visible class blood flow signals were detected in 16 cases（ 61. 5%,16 /26）. Conclusions There was a certain clinical value for preoperative diagnosis of SBST by using color doppler ultrasound.The diagnostic rate should be improved by considering of both ultrasound manifestations and clinical features.