摘要
目的探讨胃神经鞘瘤的多排螺旋CT影像特征,并做病理对照分析。方法回顾性分析经手术病理及免疫组织化学确诊的16例胃神经鞘瘤及MSCT影像资料,总结其影像特征(包括部位、大小、形态、边缘、密度及强化方式)与病理结果。结果 16例共16个病灶,位于胃体部15例、胃窦部1例,MSCT图像病灶多呈边界清楚的类圆形稍低密度肿块影,其中15例病灶内部密度基本均匀,无明显的囊变坏死或钙化,多期增强扫描呈轻中度较均匀持续性渐进性强化,1例病灶中央可见明显囊变坏死,且伴周围多发淋巴结肿大,平扫密度不均匀,增强扫描呈明显不均匀强化。术后病理镜下多表现为分界不清的长梭形细胞交叉条索状排列,呈Antoni A区表现,胞质红染,肿瘤边缘常可见淋巴细胞袖套。免疫组化16例病例S-100均为阳性,其中9例强阳性,7例中等阳性;16例Ki-67均≤15﹪,2例在CD34、CD117中表达弱阳性,3例SMA阳性(其中2例为弱阳性,1例为中等阳性),16例Desmin均为阴性。结论胃神经鞘瘤的MSCT表现具有一定的特征性,并与病理表现相对应。
Objective To investigate the image features of gastric schwannomas on the MSCT and their correlatins with pathological findings. Methods We retrospectively analyzed 16 cases of gastric schwannoma, all of whom had undergone preoperative MSCT examination and were confirmed by surgery and histopathologic analysis. Results There were 16 masses in 16 cases, among which 15 located in the body of stomach and one in the sinuses ventriculi. On MSCT, 15 masses appeared to be round masses with clear boundary and uniform low attenuation, no obvious necrosis or calcification, moderate, uniform and continuous progressive enhancement pattern were found. 1 mass was shown with inhomogeneous density and had enhancement with liquefaction necrosis in the center and some enlarged lymph nodes in peripheral region. The tumors were mainly composed of spindle shaped cells which were arranged in a palisade manner with obscure boundary. Lymphocyte sheath could often be seen on the edge of the tumor. In immunohistopathological analysis, all 16 cases were positive in S-100, among which 9 cases were strongly positive and 7 cases were moderate positive, while none showed positive in Desmin. In our group, Ki-67 were no more than 15 % in all cases, only two cases were weakly positive expression on CD34 and CD 117, respectively. Besides 3 cases were SMA positive, including 2 cases weaMy positive and 1 case medium positive. Conclusion MSCT features of GS have some characteristics, and they are corresponding to pathology.
出处
《功能与分子医学影像学（电子版）》
2017年第3期1259-1263,共5页
Functional and Molecular Medical Imaging(Electronic Edition)
