多层螺旋CT结合MRI对胃肠道间质瘤病理危险度分级的诊断价值

The Diagnostic Value of Multi-slicespiral CT Combined with MRI in Pathologicah Risk Grading of Gastrointestinal Stromal Tumors

文章探讨胃肠道间质瘤(GISTs)的多层螺旋CT及MRI征象对其病理危险程度分级的诊断价值。回顾性分析40例经手术、病理证实的GIST患者的MSCT及MRI表现,对肿瘤进行分析,了解其生长的部位和方式、形状、最大半径、是否有溃疡、实性成分密度、强化的方式和程度程度、MRI信号、表观扩散系数(ADC)值与病理危险程度分级之间关系。结果GISTs发生于胃部18例,小肠9例,结肠6例,大网膜及肠系膜5例,直肠1例,食管1例,小肠多发间质瘤(3处)1例。病理分级:极低危险度5例,低度危险16例,中危险度12例,高度危险7例。不同危险程度分级肿瘤的发生部位、肿瘤最大径、生长方式、实性成分密度、有无溃疡、形态是否规则、表观扩散系数(ADC)值差异均有统计学意义(均P<0.05),实性部分强化程度、强化方式差异无统计学意义(均P>0.05)。GIST的MSCT及高场MRI表现具有一定特征性,且与病理危险程度分级具有密切关系,对指导临床治疗和预后的评估有重要价值。

This article discusses the diagnostic value of multi-slice spiral CT and MRI signs of gastrointestinal stromal tumors(GISTs)in their pathological risk grading.CT findings of 40 cases with pathologically proved GIST were retrospectively analyzed.The relationship between GIST maximum diameter,location,mode of growth,shape,contour,tumor composition,ulcer,degree of enhancement,enhancement mode,MRI signal,apparent diffusion coefficient(ADC)values,and pathological risk grade were analyzed.Results The locations of GISTs in descending order of frequency were the stomach(n=18),small bowel(n=9),colon(n=6),omentum and mesentery(n=5),rectum(n=1),esophagus(n=1)40 cases there were 5 cases of very low degree of risk,16 cases of l low degree of risk and 9 cases of moderate or high in risk degree.For the three different grades of GISTs,there were statistical significances in the location of tumors with different risk degrees,maximum diameter,mode of growth,density,ulcer,the regularity of shape,Apparent diffusion coefficient(ADC)value,metastasis,and increment index(all of P<0.05).However,there were no statistical significances in enhancement degree and enhancement mode(P>0.05).MSCT and high field MRI of the GIST are characteristic.It has important value in the diagnosis and evaluation of the risk level of the tumor,which is helpful for clinical preoperative treatment and determination of the prognosis.