超声技术在胃肠道间质瘤诊断中的应用价值

目的探讨胃肠道间质瘤的超声表现及其诊断价值。方法对25例病理证实为胃肠道间质瘤患者的超声表现与手术病理表现进行回顾性分析。结果 25例病理诊断高度恶性13例,低度恶性5例,潜在恶性7例。术前超声表现:(1)部位:肿瘤位于胃部7例,小肠11例,大肠4例,肠系膜3例;(2)大小:9例肿瘤直径5cm,16例肿瘤直径≥5cm,肿瘤大小与病理分类具有一定的相关性,肿瘤越大恶性程度越高;(3)形态:肿块呈类圆形或椭圆形19例,呈分叶状6例。(4)回声:呈不均匀低回声18例,呈低回声中伴有不规则的液性无回声区3例(其中2例伴点片状高回声),呈均匀回声4例;(5)生长方式:肿块以膨胀性生长为主20例,小肠和大肠间质瘤的检出病例明显高于胃部,但彩色多普勒检查血流特征无特异性;(6)单发多发:单发肿瘤18例,多发肿瘤7例。术前超声检出肿瘤25例,超声与病理诊断符合19例,不符合6例。结论超声有助于胃肠道间质瘤的检出,肿瘤直径≥5cm、外生性生长、回声不均匀是胃肠道间质瘤的重要超声征象。

Value of ultrasound in the diagnosis of gastrointestinal stromal tumors

Objective To investigate the value of ultrasonography in the diagnosis of gastrointestinal stromal tumor （GIST） by analyzing the GIST findings. Methods Ultrasonic and surgery findings were reviewed retrospectively in 25 cases with GIST ~＇onfirmed by pathology. Results The tumors in the 25 patients were divided into high malignancy （13 ~.ases）,low malignancy （5 cases） and benign （7 cases） by pathologic classification. Ultrasonic findings before surgery were as follows ： （ 1 ） Position ： The tumors in 7 lesions were located stomach, 11 in small bowel, 4 in colon, 3 in mesentery. （2） Size：9 cases of tumor size were 〈 5 em,16 cases of tumor size were 〉~5em . There would be correlation between tumor diameter and pathological classification , the tumor were more larger, and malignant degree were more higher. （3） Morphology Tumors were oval or ellipse in 19 lesions, lobular in 6. （4） Echo Tumors were even echo in 4 cases, uneven low echo in 18 , low echo in 3 complicated with irregular liquefied without echo （2 of them Showed patches of dense high echo）. （5） Growth pattern of 20 lesions mainly expanded outward. The detec- tion rates of intestinal and colonic stromal tumors were obviously higher than that of stomach. But there was a lack of specificity in CDFI diagnosis for GIST. （6） Single or multiple occurrence Tumors were Single occurrence in 18 cases, multiple occurrence in 7. Ultrasonography diagnosis before surgery were positive in 25 cases while pathology was in 19 cases. Conclusion Ultrasonography is superior for GIST diagnosis. Tumor size ≥5 cm, exophytic growth and uneven inner echo are significant sonographic characteristics of GIST.