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目的:分析胃黏膜下肿瘤(gastric submucosal tumors,SMTs)的CT表现,以提高对该类病变的认识。方法:回顾性分析39例经术后病理证实的SMTs患者的CT资料,分析总结其特征表现。结果:39例SMTs患者中,间质瘤(gastric stromal tumor,GST)19例,影像表现为圆形、椭圆形或分叶状肿块,肿块实性部分增强后呈均匀或不均匀中度至明显强化,静脉期强化程度高于动脉期,17例GST长轴与胃壁垂直,14例表面覆盖完整黏膜,4例病变出现钙化,所有患者胃周未见肿大淋巴结;神经鞘瘤6例,表现为密度均匀的肿块,较少出血、坏死及囊变,仅2例患者病灶表面有小溃疡形成,增强后呈中度至明显强化,2例患者病灶周围出现肿大淋巴结;淋巴瘤8例,表现为范围较广的胃壁增厚而无梗阻,病灶长轴与胃壁平行,强化不明显,7例胃周出现肿大淋巴结;异位胰腺6例,表现为扁平状肿块影,增强后明显强化,强化方式与正常胰腺类似,1例见中央导管征。结论:SMTs病灶多在CT图像上有特征性表现,CT检查及多平面重组可清晰显示病灶的形状、大小、强化方式及胃腔内外情况等,对SMTs的诊断及鉴别均具有重要意义。
OBJECTIVE: To analyze the CT findings of gastric submucosal tumors (SMTs) in order to improve the understanding of these lesions. Methods: The CT data of 39 cases of SMTs confirmed by postoperative pathology were retrospectively analyzed, and their characteristics were analyzed. Results: Nineteen patients with SMTs had 19 gastric stromal tumor (GST). The images showed round, oval or lobulated masses. The solidity of the masses showed uniform or uneven moderate to obvious Fortified 17 cases of GST long axis and gastric wall vertical, 14 cases covered the whole surface of the mucosa, 4 cases of calcification calcification, all patients had no enlarged lymph nodes in the stomach; Schwannoma in 6 cases, the performance Only two patients had small ulceration on the surface of the lesion, enhanced to a moderate to significant enhancement, and two patients had enlarged lymph nodes around the lesion. There were 8 lymphomas, Manifested as a wide range of gastric wall thickening without obstruction, the long axis of the lesion parallel to the stomach, the enhancement was not obvious, 7 cases of gastric lymph nodes appear enlarged; ectopic pancreas in 6 cases, showed flat-like mass, enhanced significantly enhanced , Strengthen the way similar to normal pancreas, 1 case of central catheter signs. Conclusion: Most of SMT lesions have characteristic features in CT images. CT examination and multiplanar reconstruction can clearly show the shape, size, enhancement mode of gastric lesion and the situation inside and outside of gastric cavity, which are of great significance for the diagnosis and identification of SMTs.