中国癌症杂志 ›› 2016, Vol. 26 ›› Issue (5): 409-413.doi: 10.3969/j.issn.1007-3969.2016.05.010

• 论著 • 上一篇    下一篇

罕见及少见部位间质瘤的影像学表现

周旻雯1,王 坚2,徐 宇3,常 才1   

  1. 1. 复旦大学附属肿瘤医院超声诊断科,复旦大学上海医学院肿瘤学系,上海200032 ;
    2. 复旦大学附属肿瘤医院病理科,复旦大学上海医学院肿瘤学系,上海200032 ;
    3. 复旦大学附属肿瘤医院胃及软组织外科,复旦大学上海医学院肿瘤学系,上海200032
  • 出版日期:2016-05-30 发布日期:2016-06-23
  • 通信作者: 常才 E-mail:changcai@sina.com

The imaging features of rare stromal tumor

ZHOU Minwen1, WANG Jian2, XU Yu3, CHANG Cai1, PENG Weijun4   

  1. 1.Department of Ultrasound, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 2. Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 3. Department of Stomach and Soft Tissues, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2016-05-30 Online:2016-06-23
  • Contact: CHANG Cai E-mail: changcai@sina.com

摘要: 背景与目的:间质瘤为较常见的消化道间叶肿瘤,对于其典型表现病例目前已有一定的认识,但对于发生于少见部位或影像学表现不典型的病例诊断常较困难。该研究总结了此类病例的影像学表现,旨在影像学上提高对该病的认识。方法:回顾性分析复旦大学附属肿瘤医院550例经病理证实为间质瘤病例的临床、影像学及病理资料,剔除资料不完整者,并根据间质瘤的典型影像学表现筛选出49例进行研究。结果:在49例病例中,40例病理证实为胃肠道间质瘤,其中22例发生于少见部位(腹膜后12例,大网膜及肠系膜3例,食道5例,前列腺2例),16例发生了较为明显的囊变,7例可见粗大钙化;余9例病理证实为胃肠道外间质瘤。危险度分级分析结果显示,在少见部位病例中19例为高度,囊变病例中15例为高度,胃肠道外间质瘤中7例为高度。结论:罕见及少见部位间质瘤多发生于少见部位,可产生明显的囊变,并可伴有粗大的钙化灶,且其危险度分级常较高,综合分析其临床特点及影像学表现有助于提高诊断的正确率。

关键词: 间质瘤, CT, 磁共振成像

Abstract: Background and purpose: Stromal tumor is one of the common gastrointestinal mesenchymal tumors. There is certain understanding about the typical cases. However, the diagnosis of those occurring in rare location or with rare imaging findings is often difficult. This research summarized this kind of cases, in order to increase the radiological knowledge of the disease. Methods: This study retrospectively analyzed clinical, radiological and pathological data from 550 patients who had stromal tumor confirmed by pathology in our hospital. Those with incomplete data were eliminated. Forty-nine patients were selected for further study according to the typical imaging findings. Results: Among these 49 patients, 9 were pathologically confirmed to have extra-gastrointestinal stromal tumor, while 40 patients had gastrointestinal stromal tumor. Among the patients with gastrointestinal stromal tumor, 22 were found in rare locations, 12 in retroperitoneal space, 3 in omentum majus and mesenterium, 5 in esophagus, and 2 in prostate. Obvious cystic degeneration was found in 16 patients. Bulky calcification, such as flake or annulus, was found in 7 patients. The analysis result of risk-stratification showed 19 patients were confirmed as high-grade among the patients with tumors found in rare locations, 15 as high grade among those with obvious cystic degeneration, and 7 as high-grade among those with extra-gastrointestinal stromal tumor. Conclusion: Rare stromal tumor often occurs in the locations, such as retroperitoneal space, omentum majus and mesenterium. Obvious cystic degeneration and bulky calcification can be seen. The risk-stratification of these patients often showed high-grade. Comprehensively analyzing its clinical features and imaging findings can help improve the diagnostic accuracy.

Key words: Stromal tumor, CT, MRI