胃非上皮源肿块的影像诊断

目的 探讨胃非上皮源肿块的影像学特点及诊断方法的评价.方法 回顾分析经手术、病理证实的胃非上皮源肿块49例,其中经X线钡餐检查41例,CT 7例,MRI 10例,B超19例.结果 胃平滑肌类肿瘤38例,神经鞘瘤4例,间质瘤2例.上述病例X线表现为边界清楚肿块伴附近粘膜推移;CT呈密度均匀、轮廓清楚之肿块,增强后有强化;MR成像T1WI呈肌肉样等信号,T2WI呈中高信号;B超多表现为均质低回声区.胃脂肪瘤3例,X线表现肿块形态、位置可变;CT、MRI有典型脂肪影像表现.异位胰腺2例,呈光滑隆起病灶,其中心可凹陷.结论 胃非上皮源肿块以平滑肌类肿瘤最多,胃双重对比造影有特征性表现,X线可作为首选检查方法,CT或MRI对肿块进一步定位、定性有价值.

Imaging diagnosis of nonepithelial gastric masses

Objective To discuss the imaging diagnostic features of nonepithelial gastric masses and to evaluate this diagnostic methods. Methods Forty-nine cases of nonepithelial gastric mass confirmed by surgery and pathology were reviewed and analyzed, of which 41 cases was diagnosed by X-ray barium contrast examination, 7 cases by CT, 10 cases by MRI, and 19 cases by ultrasound. Results Thirty-eight cases were diagnosed as gastric leiomyoma, 4 cases as neurilemmoma, and 2 cases as interstitialoma, which appeared as clear marginal mass with displacement of surrounding mucosa by X-ray examination, and presented as well-circumscribed mass and homogeneous density on CT which had a uniform enhancement pattern. Muscle-like signal was identified on MRI. Homogeneous hypoechoic areas were mostly detected on ultrasound. Three cases were diagnosed as gastric lipoma with changeable shape and localization on X-ray and typical fat component on CT or MRI. Two cases were diagnosed as heterotopoic pancreas manifested as smooth elevated lesion with central umbilication. Conclusion Majority of nonepithelial gastric mass are found to be smooth muscle tumor with typical features on air-barlum double contrast. X-ray examination is the preferred choice and CT or MRI plays a role in further coffirming the localization and qualitation of the mass.