胃神经鞘瘤CT表现

CT Manifestations of Gastric Schwannoma

目的探讨胃神经鞘瘤（GS）的CT影像学表现,以提高对该病诊断的准确率。方法搜集本院2011年1月至2016年11月经病理证实的7例GS患者的影像学及临床资料,所有患者均行多层螺旋CT检查,其中3例行CT平扫加增强扫描,4例仅行CT增强扫描。患者临床表现以上腹部隐痛不适为主。结果 7例患者中,发生在胃体4例,胃窦2例,胃底1例,其中6例表现为边界清楚、单发的类圆形、椭圆形肿块,病灶平扫CT值平均为38 HU,增强扫描均呈渐进性强化,CT值平均升高15.28 HU;另一例病灶位于胃底,表现为胃壁增厚。其中2例可见钙化及溃疡形成。7例病灶中向腔外生长4例,向腔内、外同时生长2例,另一例为腔内的局部黏膜隆起。结论 GS CT上常表现为边界清楚、密度均匀的肿块,增强后静脉期强化高于动脉期,部分含钙化及溃疡,出血、囊变及坏死少见,这些表现有助于该病的诊断,为临床进一步治疗提供指导作用。

Objective To explore the CT manifestations of Gastric Schwannomas in order to improve the accuracy of the diagnosis of GS. Methods 7 cases of Gastric Schwannomas confirmed by surgery and pathology were collected from Jan.2011 to Nov.2016 in our hospital,only 4 cases of which were performed contrast CT while 3 were performed NCCT and contrast CT scanning. Clinical symptoms of GS are not typical. Patients usually feel uncomfortable with or without the upper abdominal pain. Results Of those 7 cases,4 cases occurred in the gastric body,2 cases in the antrum of stomach,and one in the bottom of the stomach. 6 of those show round-like or oval solitary mass with clear margine. The mean CT value of NCCT is 38 HU,and all the lesions after contrast show gradual enhancement,with an average increase of 15. 28 HU. Another one case was located in the bottom of stomach resulting in the thick wall. 2 of those show calcification and ulceration.These lesions include extraluminal growth in 4 cases,duplexgrowth in 2 cases and mucosa thickened in one case. Conclusion Gastric schwannomas appear mostly as well-defined,homogenous,delayed-enhanced tumors on NCCT and enhanced CT without signs of hemorrhage,necrosis,cystic changes. Some of them show calcification as well as ulceration. These CT features could help the diagnosis and the clinical treatment of Gastric Schwannomas to some extent.