腹内型侵袭性纤维瘤病与间质瘤的CT鉴别诊断

CT Differential Diagnosis of Intra-abdominal Aggressive Fibromatosis and Stromal Tumors

目的:腹内型侵袭性纤维瘤病和间质瘤在诊断上易于混淆,通过对CT征象进行对比分析,进而总结两者的鉴别诊断要点。方法:收集7例腹内型侵袭性纤维瘤病和9例间质瘤患者的资料,分析其平扫与三期增强的CT表现,并对两者的CT征象进行统计分析。结果:两者发生部位、囊变或坏死、强化时相、强化程度的P值均为0.01,差异具有显著性,对两者的鉴别诊断有较高价值,其中强化时相和程度有重要价值;两者在病灶的大小、形态、边界和病灶内的血管、出血、气体、钙化情况上差异无显著性,对鉴别诊断有一定价值。结论:当病灶位于胃肠道外、无囊变或坏死、增强扫描呈轻度强化、时间密度曲线呈缓慢上升的直线型时多考虑腹内型侵袭性纤维瘤病,可进一步结合MRI进行鉴别诊断;当病灶位于胃肠道壁、有囊变或坏死、增强扫描呈中度至明显强化,时间密度曲线呈速升缓降的抛物线型时多考虑间质瘤。

Objective:Intra-abdominal aggressive fibromatosis and stromal tumors are easily confused in diagnosis,so comparative analysis the CT findings of both,to summary their key points of differential diagnosis.Methods:The difference of both in sites,cystic degeneration or necrosis,enhancement phase and enhancement degree were significant(P=0.01),it has high value for differential diagnosis,among them,enhancement phase and enhancement degree have important value.There was significant difference between both in the size,morphology and boundary of the lesion,as well as blood vessels,bleeding,gas and calcification in lesions,it has certain value for differential diagnosis.Conclusion:If the lesion is located outside the gastrointestinal,without cystic degeneration or necrosis,enhanced scan showed slight enhancement,and time-density curve showed slowly ascending linear type,we should consider intra-abdominal aggressive fibromatosis.If the lesion is located in the gastrointestinal wall,with cystic degeneration or necrosis,enhanced scan showed moderate to marked enhancement,and time-density curve showed parabola type,we should consider stromal tumors.