螺旋CT对胃贲门平滑肌瘤的诊断价值

Value of spiral CT in diagnosis of leiomyoma of gastric cardia

目的:通过对胃贲门平滑肌瘤的CT影像学特征进行分析,提高对胃贲门平滑肌瘤的诊断水平。方法:回顾性分析经手术切除并经病理证实的16例贲门平滑肌瘤患者的CT影像学特征。所有患者行CT平扫及动脉、门静脉双期增强扫描。结果:16例贲门平滑肌瘤的CT表现为边界清楚的软组织肿块;有腔内生长(n=7)、腔内外跨壁生长(n=6)及腔外生长(n=3)3种生长方式;呈不规则形(n=6)、类圆形(n=5)、扁平形(n=3)及分叶状(n=2)4种形态。三期动态CT扫描中,肿瘤的CT均值分别为42.3 HU(平扫)、49.0HU(动脉期)和56.6 HU(门静脉期),门静脉期表现为轻度强化(n=3)和中度强化(n=13)。肿瘤伴发溃疡及胃周淋巴结肿大各有6例。结论:CT多平面重建有利于胃贲门平滑肌瘤形态多样性的显示,结合CT强化特征有助于术前诊断。

Objective： To analyze the CT features of leiomyoma of gastric cardiac, and to improve the diagnostic level. Methods： The CT features of 16 patients with pathology-proven leiomyomas of gastric cardia were retrospectively reviewed. All 16 patients underwent non-enhanced and contrast-enhanced CT in arterial phase and portal phase. Results： The leiomyomas showed well-defined solid masses, with endoluminal（n=7）, mixed（n=6） or extraluminal（n=3） growth patterns. There were 4 contours： irregular（n=6）, circular（n=5）, flattened（n=3） or lobulated（n=2）. The mean CT values were 42.3 HU（plain scan）, 49.0 HU（arterial phase）, and 56.6 HU（portal phase）, respectively. In portal phase, mild enhancement was found in 3 cases and moderate enhancement in 13 cases. Six cases had ulceration and 6 cases had perigastric lymph node enlargement. Conclusion： CT multi-planar reconstruction which is beneficial to reveal the diverse contour of leiomyoma of gastric cardiac, combined with CT enhanced features is helpful for preoperative diagnosis.