摘要
目的探讨胃肠道间质瘤(GIST)术后肝转移的CT表现,并参照其病理组织免疫学,了解其恶性转移程度。方法回顾性分析10例经临床手术病理证实的胃肠道间质瘤(GIST)在随诊中或经肝穿活检证实的肝转移的CT影像表现及临床资料。主要观察胃肠道间质瘤术后的转移部位、数目、大小、形态、密度、强化程度等方面。结果病灶分布:肝右叶4例,左叶2例,两叶4例。单发3例;多发者7例,病灶以3~7个居多40%(4/10)。病灶直径1cm^23cm,以2cm^5cm居多(54.3%)(25/46),5cm以上17个(37.0%)(17/46)。CT平扫:多呈结节、肿块或厚壁囊性肿物。增强扫描:动脉期呈环状或线样、点状、斑片及絮状强化为主(60.9%)(28/46);门脉期:病灶实质部分强化,坏死液化区不强化,部分病灶呈"牛眼征"(17.4%)(8/46);延迟期:多数病灶强化渐消退,其密度低于周围肝实质78.3%(36/46)。结论胃肠道间质瘤(GIST)肝转移CT表现复杂多样,以单发、较大、边缘清楚的实性、厚壁囊性肿物,动脉期边缘或实质内线样或斑点及片絮状强化较具特征性,在原发肿瘤诊断不明的情况下,应积极行肝内病灶穿刺活检。
Objective To analyze the CT image of liver metastasis in gastrointestinal stromal tumors after radical resection.Methods The clinical and CT scan data of 10 patients with liver metastasis of GIST proved by operation and pathology or liver biopsy were reviewed.Results Distribution of lesions：4cases were located in right lobe of liver,while 2 cases were located in left lobe and 4cases were located in the hepatic parenchyma.Single lesion was found in 3 cases and multiple lesions were found in 7cases.The diameter of lesions ranged between 1 cm and 23 cm and mostly varied from 2cm to 5cm（54.3%）（25/46）,17cases diameter were beyond 5cm（37.0%）（17/46）.CT noncontrast enhanced scan：The CT imaging showed tubercle,lump,cystic lump with thick wall.Enhancement scanning：The CT imaging are characterized mainly of circle enhancing or thready,globular shape,patchy enhancing in arterial phase（60.9%）（28/46）.The enhancement patterns were characterized mainly of circle enhancing with internal low density in portal phase.Some imaging present bull eye sign（17.4%）（8/46）.In delayed-phase the enhancement patterns fade away and the density is lower than surrounding liver parenchyma 78.3%（36/46）.Conclusions The CT imaging of liver metastasis patterns are variable.The cystic or solid lump are mainly of single、large and well demarcated margin.They are character of circle enhancing or thready,globular shape、patchy enhancing in arterial phase.If the primary tumor is acatalepsy,liver biopsy should be applied actively.
出处
《医药论坛杂志》
2011年第8期62-63,66,共3页
Journal of Medical Forum
关键词
胃肠道间质瘤
肝转移
体层摄影:X线计算机
Gastrointestinal stromal tumors
Liver metastasis
Tomography
X-ray computed
