小肠间质瘤多层螺旋CT表现与恶性程度相关性分析

Analysis of correlation between multi-slice spiral CT manifestations and malignant degree of small intestinal stromal tumors

目的术前准确确定胃肠间质瘤(gastrointestinal stromal tumors,GIST)危险度对后期精准治疗具有重要意义,多层螺旋CT已被应用于肿瘤的定位定性诊断,且具有独特优势。本研究分析小肠间质瘤(small intestinal stromal tumors,SIST)多层螺旋CT(multi-slice spiral CT,MSCT)表现与恶性程度相关性。方法回顾性分析2015-01-03-2018-08-26池州市人民医院16例经手术病理及免疫组化确诊的SIST患者。分析MSCT动态增强及三维重建资料,依据病理危险度分组,低危组7例,高危组9例。观察比较病变的部位、大小、形态、生长方式、有无坏死、强化程度、肿瘤血管、表面溃疡、瘤内积气、瘤周脂肪浸润及有无转移的差异。结果16例患者均为单发病变。低危组与高危组在肿瘤大小(P<0.001)、肿瘤形态(P=0.035)和生长方式(P=0.045)比较,差异有统计学意义。高危组肿瘤直径大于低危组;高危组肿瘤形态多呈不规则或分叶状(88.9%),低危组多呈圆形或椭圆形(71.4%);高危组肿瘤多表现为外生型生长(88.9%)。结论MSCT动态增强结合三维重建技术对SIST危险度的预测具有一定的价值。通过显示肿瘤的大小、形态和生长方式方面特征,有助于对肿瘤的生物学行为进行一定程度的预测,对术前疾病评估具有一定意义。

OBJECTIVE It is important for late precise treatment to assign the risk of gastrointestinal stromal tumors.multi-slice CT(MSCT)has been applied in the localization and qualitative diagnosis of tumors with unique advantages.The paper analyzed the correlation between multi-slice CT.manifestations and malignant degree of small intestinal stromal tumors(SIST).METHODS Sixteen patients with SIST were confirmed by operation,pathology and immunohistochemistry from 2015-01-03 to 2018-08-26 at Chizhou People’s Hospital.Their MSCT dynamic enhancement and three-dimensional reconstruction data were analysised.According to the pathological risk,there were 7 cases in low-risk group and9 cases in high-risk group.The location,size,shape,growth pattern,necrosis,enhancement,tumor vessels,surface ulcers,pneumoma,peritumoral fat infiltration and metastasis of the lesions were observed and compared.RESULTS All the16 patients had single lesion,there were 7 lesions with low risk,9 with high risk.There were significant differences in CT features of SIST between low-risk group and high-risk group in tumor size(P<0.001),tumor morphology(P=0.035),tumor growth pattern(P=0.045).The diameter of tumors in high-risk group was larger than that in low-risk group;the shape of tumors in high-risk group was irregular or lobulated(88.9%),while that in low-risk group was round or elliptical(71.4%);and in high-risk group,the growth of tumors was exogenous(88.9%).CONCLUSIONS MSCT dynamic contrast-enhancement combined with 3 Dreconstruction has certain value in predicting the risk of SIST.By showing the size,shape and growth pattern of tumors,it can help to predict the biological behavior of tumors to a certain extent,which is of great significance for preoperative disease assessment.