15例胃肠道间质瘤MRI回顾性研究.docVIP

15例胃肠道间质瘤MRI回顾性研究[摘要]目的 讨论胃肠道间质瘤(GIST)的MRI的影像诊断。方法 回顾性分析本院15例经手术及病理证实的GIST MRI影像特征。结果 15例GIST中12例边界清晰,可见不完整包膜及肿块内不规则坏死区,直径3～18cm。T1加权图像上呈较低信号或等信号,T2加权图像上呈不均匀等、高信号,增强扫描不均匀较明显强化;3例可见肿块内出血、坏死的MRI信号特点。结论MRI可清楚定位,对临床诊断该病提供了有价值的依据。 [关键词]胃肠道间质瘤; MRI [中图分类号] R735 [文献标识码] A [文章编号] 1673-9701(2010)01-60-02 Magnetic Resonance Imaging of Gastro-intestinal Stromal Tumor:A retrospective Analysis of of 15 Cases LUO Guoyao Deparment of Radiology,Dongguan Municipal Changan Hospital,Dongguan 523843,China [Abstract] ObjectiveTo discuss magnetic resonance imaging(MRI) characteristics of gastro-intestinal stromal tumors(GISTs). MethodsA retrospective analysis was made of the data of 15 cases of GISTs confirmed by postoperation and pathology. ResultsTwelve cases of 15 showed a clear boundary,incomplete capsule and irregular tumor necrosis,their diameter ranged from 3 to 18 cm,T1-weighted images showed low or equal signal,T2-weighted images showed asymmetric,high or equal signal,and enhanced scanning significantly enhanced non- uniformity. MRI signals showed necrosis and hemorrhage in 3 cases. ConclusionMRI can clearly locate GISTs,providing a valuable basis for the clinical diagnosis of the disease. [Key words]Gastro-intestinal stromal tumors; Magnetic resonance imaging 胃肠间质瘤(GIST)是胃肠道最常见的间质肿瘤,以往由于对GIST认识不足,常使GIST的确诊和及时治疗带来困难,该病的MRI报道不多。本文回顾性的分析2005～2008年来我院收治的胃肠道间质瘤15例的MRI特点,以提高对 胃肠道间质瘤的认识及诊断准确性。 1 材料与方法 本组共收集胃肠道间质瘤病例15例,其中男9例,女6例。年龄48～72岁,平均年龄60岁。所有病例均由手术及病理证实。GIST一般仅在切除术和病理检查后确诊,MRI显示GIST的T1加权图像显示为低密度信号,T2加权图像为高密度信号。 使用美国GE型0.2T磁共振仪,常规进行肝脏横断扫描用自旋回波(SE)序列,一般为12～16层,层厚8mm或10mm,层距10mm或12mm。TlWI:TR500ms～TE20ms;T±WI:TR2000ms,TE80～90ms。必要时加扫矢状面或冠状面MRI。检查前病人禁食6h以上,检查时仰卧平静呼吸,以尽量控制腹式呼吸影响。 2 结果 15例GIST中12例边界清晰,可见不完整包膜及肿块内不规则坏死区,直径3～18cm。T1加权图像上呈较低信号或等信号(图A);T2加权图像上呈不均匀等、高信号,增强扫描不均匀较明显强化(图B);3例可见肿块内出血,坏死和出血MRI信号特点。对周围器官或组织有不同程度压迫、推移征像,恶性病例分界不清。 3 讨论 3.1 临床表现 GIST的临床表现多取决于肿瘤大小及所在部位。GIST男性较女性高发[1],占所有胃肠间质肿瘤的80%和所有小肠恶性肿瘤(淋巴瘤除外)的20%左右。GIST的历史发病率难以判定,