胃肠道平滑肌肉瘤的临床及影像学诊断价值

Clinical and Imaging Diagnosis Value of Gastrointestinal Leiomyosarcoma

目的对胃肠道平滑肌肉瘤的临床特征及其影像学诊断情况进行分析和研究。方法回顾分析2014年1月—2016年12月该院接收的手术病理确诊的43例胃肠道平滑肌肉瘤患者的临床资料,分析影像学检查结果 ,总结临床特征。结果该组43例患者通过X线检查,胃平滑肌肉瘤21例(14例位于腔内,2例腔外,5例合并腔内外);小肠平滑肌肉瘤20例(16例位于腔外,3例腔内,1例合并腔内外),其中14例边缘存在分叶征象,18例存在溃疡表现;2例结肠平滑肌肉瘤,均位于腔内,B超显示腔内实性肿块;CT平扫大多数表现为不规则分叶状态,且内部密度不均,增强扫描肿瘤实质部显著强化,坏死区域无强化。结论胃肠道平滑肌肉瘤多发于胃及空肠,且主要是腔内型;小肠平滑肌肉瘤主要是腔外型,综合应用影像学检查能可有效提升诊断准确率。

Objective To analyze and research the clinical features and imaging diagnosis situation of gastrointestinal leiomyosarcoma. Methods The clinical data of 43 cases of patients with gastrointestinal leiomyosarcoma diagnosed by the operative pathology admitted and treated in our hospital from January 2014 to December 2016 were retrospectively analyzed and the imaging examination results were analyzed and the clinical features were summarized. Results In this group, the X ray examination showed that there were 21 cases with gastrointestinal leiomyosarcoma（ 14 cases were intracavity, 2 cases were extracavity and 5 cases were intracavity and extracavity）, and 20 cases were with small intestinal leiomyosarcoma（ 16 cases were extracavity, 3 cases were intracavity and 1 case was intracavity and extracavity）, lobulated signs occurred to 14 cases, ulcer manifestations occurred to 18 cases, colon leiomyosarcoma occurred to 2 cases and intracavity, and the B ultrasound showed the intraluminal solid masses, most manifestations of CT plain scan showed the irregular lobulated state, and the inner density was uneven, and the enhancement scan showed that the tumor solid site was obviously enhanced and there was no enhancement in the necrosis area. Conclusion Most of gastrointestinal leiomyosarcoma occur in the stomach and jejunum, and most of them were of the intracavity type, and most of the small intestinal leiomyosarcoma were of the extracavity type, and the comprehensive application of imaging examination can effectively improve the diagnosis accurate rate.