肠系膜间质瘤的CT诊断价值

目的：探讨肠系膜间质瘤的CT表现。方法：回顾性分析经手术病理证实的13例来源于肠系膜的间质瘤的CT表现特点。结果：肿块位于小肠系膜7例，结肠系膜6例。分叶状6例，不规则形3例，圆形或类圆形4例。瘤体最大直径为2．5-18．4cm，平均约为（10．5±4．9）cm。肿块密度均匀5例；肿块内坏死8例，肿块内液气平面2例。增强后肿瘤均呈不均匀轻度一明显强化，肿瘤坏死、囊变、含气无明显强化。按照肿瘤实性部分强化方式分为：Ⅰ型：静脉期下降型（8例），动脉期轻度一明显均匀或不均匀强化，动脉期病灶内可见增粗、增多的肿瘤血管强化，而静脉期强度程度下降，低于动脉期。Ⅱ型：静脉期升高型（5例），动脉期轻度一明显均匀或不均匀强化，静脉期强化程度持续增加，高于动脉期，呈渐进性强化特点。3例出现瘤体邻近肠系膜淋巴结肿大。结论：肠系膜间质瘤CT表现具有一定特征性，CT检查对该疾病的诊断及鉴别诊断有重要价值。

CT in the diagnosis of mesenteric stromal tumors

Objective： To discuss the CT appearance of mesenteric stromal tumors. Methods： Imaging findings of 13 pa- tients with histopathologieally proven mesenteric stromal tumors were analyzed retrospectively. Results： The lesions located in the mesostenium （n=7） and mesocolon（n=6）. The shape was lobulated in 6 cases, irregular in 3 cases and round or oval in 4 cases. The mean maximal diameter of 13 lesions was （10.5±4.9） cm, ranged from 2.5 cm to 18.4 cm. Five lesions were homo- geneous solid mass, 8 lesions were heterogeneous with necrosis inside, including 2 lesions with air-fluid level. After adminis- tration of contrast medium, there was moderately or markedly homogeneous or heterogeneous enhancement in the lesions, but no enhancement was found in necrosis and air within the lesions. The lesions were divided into 2 types according to the pat- tern of enhancement of the solid component. Type Ⅰ, decrease enhancement in venous phase （n=8）： there was homogeneously or heterogeneously mild to marked enhancement in arterial phase, with thickening and increasing of tumor vessels, then the degree of enhancement was decreasing in venous phase; Type Ⅱ, increase enhancement in venous phase （n=5）： there was ho- mogeneously or heterogeneously mild to marked enhancement in the arterial phase. The degree of enhancement increased grad- ually in venous phase, higher than arterial phase, appeared as progressive enhancement. There was local mesenteric lym- phadenectasis in 3 cases. Conclusion： CT findings of stromal tumors in the mesentery have some characteristics, and impor- tant value in correct diagnosis and differential diagnosis.