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目的评价螺旋CT与重建技术对小肠间质瘤的诊断价值。方法回顾性分析经手术病理证实的24例小肠间质瘤的CT扫描与MPR、STS-MIP重建表现。结果24例患者中,23例间质瘤单发于小肠,1例伴胃肠道多发;其中良性间质瘤17例,恶性间质瘤7例。肿瘤大小约2.5～12cm。主要发生部位:空肠12例,回肠10例,十二指肠2例。小肠间质瘤的主要影像特征:(1)肿块位于肠腔外15例,肠腔内或呈肠壁增厚7例,见腔内龛影形成2例。(2)肿块呈圆形或类圆形19例,分叶状或不规则形5例。(3)肿块密度较均匀12例,密度欠均匀7例,内有地图样改变5例。(4)动态增强扫描强化较均匀19例,其中动脉期呈轻、中度不均匀强化,门脉期及平衡期明显强化16例,动脉期明显强化1例,无明显强化2例;不均匀强化,呈快进快出模式5例。(5)肿块边界不清,邻近结构侵袭2例。(6)MPR和STS-MIP行血管重建可见肠系膜动脉直接进入肿瘤供血20例。螺旋CT及重建技术对小肠间质瘤定性和定位诊断的正确率分别为91.7%(22/24)和95.8%(23/24)。结论螺旋CT与MPR、STS-MIP重建对小肠肿瘤的定性和定位诊断具有重要的临床价值。
Objective To evaluate the diagnostic value of spiral CT and reconstruction techniques for small intestinal stromal tumors. Methods The CT scan and MPR, STS-MIP reconstruction of 24 cases of small intestinal stromal tumors confirmed by surgery and pathology were retrospectively analyzed. Results Of the 24 patients, 23 cases of stromal tumors were solitary in the small intestine and 1 in the gastrointestinal tract. There were 17 cases of benign stromal tumors and 7 cases of malignant stromal tumors. Tumor size of about 2.5 ~ 12cm. The main site of occurrence: jejunum in 12 cases, ileum in 10 cases, duodenal in 2 cases. Intestinal stromal tumor of the main imaging features: (1) mass located in the intestinal lumen 15 cases, intestinal or intestinal wall thickening in 7 cases, see the niche shadow in 2 cases. (2) Mass was round or round shape in 19 cases, lobulated or irregular shape in 5 cases. (3) The density of the tumor was more uniform in 12 cases, the density was less uniform in 7 cases, and there were 5 cases in the same pattern. (4) Dynamic contrast-enhanced MRI was performed in 19 cases. The arterial phase was mild and moderate inhomogeneous enhancement. The portal phase and balance phase were significantly enhanced in 16 cases, arterial phase was significantly enhanced in 1 case, and there was no obvious enhancement in 2 cases. Strengthen, was fast into fast mode 5 cases. (5) tumor boundary is unclear, adjacent structure invasion in 2 cases. (6) MPR and STS-MIP vascular reconstruction visible mesenteric artery directly into the tumor blood supply in 20 cases. The accuracy of spiral CT and reconstruction in the diagnosis and localization of intestinal stromal tumors were 91.7% (22/24) and 95.8% (23/24), respectively. Conclusion Spiral CT, MPR and STS-MIP reconstruction have important clinical value in the diagnosis and localization of small bowel tumors.