胃肠道间质瘤患者超声和MSCT征象特点分析
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摘要
目的分析胃肠道间质瘤(GIST)患者超声和多层螺旋电子计算机断层扫描(MSCT)征象特点。方法回顾性分析2016年3月-2017年12月我院接受超声及MSCT检查且经手术病理(金标准)诊断的68例单发GIST患者临床资料。比较超声及MSCT与金标准定位诊断情况差异,并分析2种检查方法对不同恶性危险度GIST的征象特点。结果 68例单发GIST病例中肿瘤位于胃部41例(60.29%),小肠19例(27.94%),结直肠8例(11.77%);其中极低危5例(7.35%),低危11例(16.18%),中危14例(20.59%),高危38例(55.88%)。MSCT定位诊断准确率明显高于超声(P<0.05)。MSCT及超声对不同危险度GIST的征象特点均显示,危险度越高者肿瘤直径越大(P<0.05),且形态不规则及边界模糊发生率越高(P<0.05);但不同危险度GIST的MSCT钙化及淋巴结转移情况、超声回声及血流情况比较,差异无统计学意义(P>0.05)。结论 MSCT及超声均能通过评估肿瘤直径、形态与边界情况以判断GIST的恶性危险度,而MSCT能更准确地判定GIST的发生部位,于后续临床治疗更有利。
Objective To analyze the signs features of ultrasound and multi-slice spiral computed tomography(MSCT)imaging in patients with gastrointestinal stromal tumors(GIST).Methods The clinical data of 68 patients with single GIST diagnosed by surgical pathology(gold standard)underwent ultrasound and MSCT from March 2016 to December 2017 in our hospital were analyzed retrospectively.The differences in the diagnosis of ultrasound and MSCT were compared,and the features of two kinds of examination methods of different malignant risk were analyzed.Results A total of 68 single GIST cases,41 cases(60.29%)located in stomach,19 cases(27.94%)in small intestine and8 cases(11.77%)in rectum.Five cases(7.35%)were extremely low risk,11 cases(16.18%)were low risk,14 cases(20.59%)were middle risk and 38 cases(55.88%)was high risk.The accuracy rate of MSCTwas significantly higher than that of ultrasound(P<0.05).The signs features of MSCT and ultrasound towards different risk GIST showed that the higher the risk of GIST was,the larger the tumor diameter was(P<0.05)and the higher the incidence rates of irregular shape and blurring boundary were(P<0.05).But there was no statistical difference in the MSCT calcification and lymph node metastasis between ultrasound and MSCT,ultrasonic echo and blood flow in GIST with different risk degrees(P>0.05).Conclusion MSCT and ultrasound can judge the malignant risk of GIST by evaluating the tumor diameter,shape and boundary,and MSCT can determine the location of GIST more accurately and it is more favorable for the follow-up clinical treatment.
Objective To analyze the signs features of ultrasound and multi-slice spiral computed tomography(MSCT)imaging in patients with gastrointestinal stromal tumors(GIST).Methods The clinical data of 68 patients with single GIST diagnosed by surgical pathology(gold standard)underwent ultrasound and MSCT from March 2016 to December 2017 in our hospital were analyzed retrospectively.The differences in the diagnosis of ultrasound and MSCT were compared,and the features of two kinds of examination methods of different malignant risk were analyzed.Results A total of 68 single GIST cases,41 cases(60.29%)located in stomach,19 cases(27.94%)in small intestine and8 cases(11.77%)in rectum.Five cases(7.35%)were extremely low risk,11 cases(16.18%)were low risk,14 cases(20.59%)were middle risk and 38 cases(55.88%)was high risk.The accuracy rate of MSCTwas significantly higher than that of ultrasound(P<0.05).The signs features of MSCT and ultrasound towards different risk GIST showed that the higher the risk of GIST was,the larger the tumor diameter was(P<0.05)and the higher the incidence rates of irregular shape and blurring boundary were(P<0.05).But there was no statistical difference in the MSCT calcification and lymph node metastasis between ultrasound and MSCT,ultrasonic echo and blood flow in GIST with different risk degrees(P>0.05).Conclusion MSCT and ultrasound can judge the malignant risk of GIST by evaluating the tumor diameter,shape and boundary,and MSCT can determine the location of GIST more accurately and it is more favorable for the follow-up clinical treatment.
引文
[1]田青水,张宝明,刘毅,等.Notch信号通路相关蛋白在胃肠道间质瘤中的表达及临床意义[J].中国普通外科杂志,2016,25(4):547-551.
[2]王源,孟刚.伴有转移的胃肠道间质瘤临床病理特征[J].临床与实验病理学杂志,2017,33(9):982-986.
[3]张学凌,赵建洪,张玲艳,等.能谱CT参数对胃肠道间质瘤危险度分级的初步研究[J].实用放射学杂志,2016,32(12):1880-1883.
[4]曹晖,汪明.胃肠间质瘤综合诊治中若干焦点问题思考[J].中国实用外科杂志,2018,38(5):485-493.
[5]闫爽.超声联合多层螺旋CT诊断胰腺癌的临床价值[J].中国CT和MRI杂志,2017,15(4):100-102.
[6]Liegl B,Hornick J L,Corless CL,et al.Monoclonal Antibody DOG1.1 Shows Higher Sensitivity Than KIT in the Diagnosis of Gastrointestinal Stromal Tumors,Including Unusual Subtypes[J].American Journal of Surgical Pathology,2009,33(3):437-446.
[7]熊振,帅晓明,高金波,等.高危胃肠道间质瘤的临床特点及预后分析[J].中华普通外科杂志,2017,32(11):914-916.
[8]闵凯,曹峰瑜,任骏,等.靶向治疗高危胃肠道间质瘤的临床疗效[J].中国普通外科杂志,2016,25(10):1408-1411.
[9]李明,张波.胃肠道间质瘤的超声诊断[J].中国医学影像学杂志,2016,24(1):36-39.
[10]石磊,徐峰.胃肠道间质瘤的MSCT表现与病理化验对照分析[J].中国CT和MRI杂志,2017,15(3):109-111.
[11]黄怀钱,邹国庆.MSCT检查胃间质瘤中的临床应用价值[J].医学影像学杂志,2016,26(2):368-370.
[12]王健,徐军良,胡红杰.≤5cm胃间质瘤的C T表现与肿瘤危险度分级的相关性[J].中华肿瘤杂志,2017,39(3):184-189.
[13]夏国金,胡珍珍,何玉麟,等.原发性小肠间质瘤MSCT强化表现与病理危险度对照分析[J].实用放射学杂志,2017,33(6):571-573,580.
[2]王源,孟刚.伴有转移的胃肠道间质瘤临床病理特征[J].临床与实验病理学杂志,2017,33(9):982-986.
[3]张学凌,赵建洪,张玲艳,等.能谱CT参数对胃肠道间质瘤危险度分级的初步研究[J].实用放射学杂志,2016,32(12):1880-1883.
[4]曹晖,汪明.胃肠间质瘤综合诊治中若干焦点问题思考[J].中国实用外科杂志,2018,38(5):485-493.
[5]闫爽.超声联合多层螺旋CT诊断胰腺癌的临床价值[J].中国CT和MRI杂志,2017,15(4):100-102.
[6]Liegl B,Hornick J L,Corless CL,et al.Monoclonal Antibody DOG1.1 Shows Higher Sensitivity Than KIT in the Diagnosis of Gastrointestinal Stromal Tumors,Including Unusual Subtypes[J].American Journal of Surgical Pathology,2009,33(3):437-446.
[7]熊振,帅晓明,高金波,等.高危胃肠道间质瘤的临床特点及预后分析[J].中华普通外科杂志,2017,32(11):914-916.
[8]闵凯,曹峰瑜,任骏,等.靶向治疗高危胃肠道间质瘤的临床疗效[J].中国普通外科杂志,2016,25(10):1408-1411.
[9]李明,张波.胃肠道间质瘤的超声诊断[J].中国医学影像学杂志,2016,24(1):36-39.
[10]石磊,徐峰.胃肠道间质瘤的MSCT表现与病理化验对照分析[J].中国CT和MRI杂志,2017,15(3):109-111.
[11]黄怀钱,邹国庆.MSCT检查胃间质瘤中的临床应用价值[J].医学影像学杂志,2016,26(2):368-370.
[12]王健,徐军良,胡红杰.≤5cm胃间质瘤的C T表现与肿瘤危险度分级的相关性[J].中华肿瘤杂志,2017,39(3):184-189.
[13]夏国金,胡珍珍,何玉麟,等.原发性小肠间质瘤MSCT强化表现与病理危险度对照分析[J].实用放射学杂志,2017,33(6):571-573,580.