CT对胃肠道异位胰腺和间质瘤的鉴别诊断

The value of CT in differential diagnosis of gastrointestinal ectopic pancreas and gastrointestinal stromal tumors

目的探讨CT对胃肠道异位胰腺和间质瘤的鉴别诊断价值。方法回顾性分析经术后病理证实的30例胃肠道异位胰腺和30例间质瘤的临床特征和CT表现。结果异位胰腺和间质瘤的生长方式、边界、病灶周围胃肠粘膜连续性、强化方式、强化程度、胃内病灶分布位置的差异有统计学意义。异位胰腺多呈腔内生长、边界清、病灶周围胃肠粘膜连续、中度均匀强化、胃部病灶以胃窦部为多。间质瘤多呈腔内腔外混合生长、边界清者比例更高、病灶周围胃肠粘膜多不连续、明显不均匀强化、胃部病灶以胃体部为多。两者病灶的长径/短径的值、形态、CT值的差异无统计学意义。结论通过比较CT图像中病灶的生长方式、边界、病灶周围胃肠粘膜连续性、强化方式、强化程度和胃内病灶分布位置能够对异位胰腺和间质瘤的鉴别诊断提供帮助。

Objective To explore the value of CT in differential diagnosis of gastrointestinal ectopic pancreas and gastrointesti- nal stromal tumors （GIST）. Methods The clinical features and CT findings of 30 gastrointestinal ectopic pancreas and 30 GISTs, which were confirmed by postoperative pathology, were retrospectively analyzed. Results The growth pattern, border, gastrointestinal mucosa continuity, enhancement pattern, enhancement grade and the location of the lesions in the stomach were significant different between the gastrointestinal ectopic pancreas and GISTs. The CT features of the gastrointestinal ectopic pan- creas more often tended toward endoluminal growth, well-defined margin, continous mucosa around the lesions, intermediate and homogeneous enhancement. The most commen location of the gastric lesions was the antrum. The CT features of the GISTs fre- quently showed mixed growth, ill-defined margin, discontinous mucosa around the lesions, high and heterogenous enhancement. The most commen location of the gastric lesions was the body. There was no significant difference in the LD/SD rate, contour and CT value between the two groups. Conclusion Gastrointestinal ectopic pancreas and GISTs can be differentiated by expolring the CT values of the growth pattern, border, gastrointestinal mucosa continuity, enhancement pattern, enhancement grade and the lo- cation of the lesions in the stomach.