MSCT影像特征对胃肠道间质瘤危险度的预测价值

The predictive value of MSCT imaging features on the pathological risk of gastrointestinal stromal tumors

目的探讨MSCT影像特征对胃肠道间质瘤(GISTs)病理危险度的预测价值。方法回顾性分析120例经手术、病理及免疫组化证实的GISTs患者的MSCT表现,分析肿瘤的发病年龄、部位、肿瘤最大径、形态、生长方式、囊变坏死、有无钙化、瘤周脂肪间隙、强化方式、瘤周或瘤内血管、强化峰值所在期、有无转移以及Ki-67增殖指数与病理危险程度分级之间关系。结果120例病例中分别有极低度和低度危险55例,中度危险28例,高度危险37例。不同危险程度GISTs在病变的部位、肿瘤最大径、形态、生长方式、囊变坏死、瘤周脂肪间隙、强化方式、瘤周或瘤内血管以及强化峰值所在期方面均有统计学差异(P<0.05);Ki-67增殖指数方面有统计学差异(P<0.05)。而不同危险度的GISTs在病变有无钙化及CT平扫、增强扫描(三期)CT值、强化峰值、Ap、Vp、Dp方面无统计学差异(P>0.05)。结论不同危险度的GISTs的多层螺旋CT(MSCT)表现存在差异,且与病理危险程度分级具有密切关系,对GISTs的诊断、临床治疗方案制订及判断预后有重要参考价值。

Objective To investigate the predictive value of MSCT imaging features on the pathological risk of gastrointestinal stromal tumors(GISTs).Methods The MSCT manifestations of 120 GISTs patients confirmed by operation,pathology and immunohistochemistry were analyzed retrospectively.The age of tumor onset,location,maximum diameter,morphology,growth pattern,cystic necrosis,calcification,peritumoralfat space,enhancement pattern,peritumoralor intratumoral vessels,peak period of enhancement,metastasis,and the relationship between Ki-67 proliferation index and pathological risk grade were also analyzed.Results Among 120 cases,there were 55 cases of extremely low and low risk,28 cases of moderate risk,and 37 cases of high risk.There were significant differences in location,tumor diameter,morphology,growth pattern,cystic necrosis,peritumoral fat space,enhancement pattern,peritumoral or intratumoral vessels,peak period of enhancement,and Ki-67 proliferation index of GISTs(P<0.05).There was no significant difference in calcification,CT plain scan,enhanced scan(3 phase),peak value and Ap、Vp、Dp of GISTs with different risk(P>0.05).Conclusion There are differences in the performance of multi-layer spiral CT(MSCT)in GISTs with different risk levels.It is closely related to the classification of pathological risk.For the diagnosis of GISTs,clinical treatment plan formulation and prognosis,it has important reference value.