胃肠道间质瘤18例的~(18)F-FDG PET/CT显像及病理对照研究

目的探讨胃肠道间质瘤的18F-FDG PET/CT显像特点及其相应病理学表现,以提高对胃肠道间质瘤的诊断水平。方法对18例病理证实为胃肠道间质瘤患者的PET/CT显像进行回顾性分析,记录、总结病灶特点,并与既往PET/CT报告及病理报告进行比较、分析。结果本组18例间质瘤,原发瘤灶均为单发,其中良性3例、潜在恶性5例、恶性10例,3例良性病变PET显像均为阴性表现,潜在恶性及恶性间质瘤15例均表现为均匀或不均匀核素异常浓聚灶,CT表现3例良性间质瘤均表现为边界清楚、光滑肿块影,潜在恶性及恶性间质瘤CT表现不一,多数病灶内可见坏死、囊变区,部分病灶内可见出血,少部分病灶内密度均匀,呈软组织密度;大部分病例可准确定位、定性诊断,少数病例定位诊断及病理学分型不明确。结论PET/CT在对间质瘤的定位及定性诊断方面具有重要价值,可鉴别间质瘤良、恶性,且一次扫描可判断肿瘤有无转移,但对于间质瘤恶性程度分级上还有一定困难,最后确诊有赖于病理组织学和免疫组化检查。

Correlation Research in 18F-FDG PET/CT Imaging and Pathology of 18 Gastrointestinal Stromal Tumors

Objective To evaluate the 18F-FDG PET/CT imaging of gastrointestinal stromal tumor(GIST) with corresponding pathology diagnoses.Methods The PET/CT imaging findings of 18 patients with GIST proved by operation and pathology were retrospectively analyzed and compared with previous PET/CT and pathology reports.Results All the primary tumors of the 18 ones were single.Of the 18 cases,3 were benign,5 were potentially malignant,and 10 were malignant.The 3 cases of benign GIST were negative in PET/CT imaging findings(no higher concentration of radionuclide in the lesions),the 15 cases of potentially malignant or malignant GIST were positive in PET/CT imaging findings(with higher concentration of radionuclide).The 3 of benign GIST revealed masses with clear margins in CT imaging findings.In the 15 cases of potentially malignant and of malignant GIST,intra-tumorous necrosis,hemorrhage or cystic changes were found in most and the rests of the tumors showed even soft-tissue density.Most GIST cases in this group could be precisely localized and qualitatively diagnosed in PET/CT imaging,except a few of the cases.Conclusion PET/CT is a useful imaging technique in the precisely localizing and qualitative diagnosis of GIST.It can differentiate the benign from the malignant GIST,and detect the tumor metastasis in one PET/CT scan.There're still some difficulties in differentiating the potentially malignant with the malignant GIST.In this case,it is histopathological and immunohistochemical examination we depend on to make a final confirmation.