胃肠道平滑肌肉瘤的临床及影像学诊断价值

目的:探讨胃肠道平滑肌肉瘤的临床及影像学诊断特征。方法:对46例经手术病理证实的胃肠道平滑肌肉瘤的起源,大小、形态进行回顾性分析。结果:X线检查:22例胃平滑肌肉瘤;23例小肠平滑肌肉瘤;1例结肠平滑肌肉瘤。胃平滑肌肉瘤14/22例病变位于腔内,2/22例病变位于腔外,6/22例病变位于腔内外;小肠平滑肌肉瘤19/23例病变位于腔外,2例位于腔内,2例位于腔内外,其大小多在6~10cm;16例边缘有分叶征象,有溃疡者22例;1例结肠平滑肌肉瘤位于腔内外,B超表现为腹腔内实性肿块;CT平扫多呈不规则分叶状,内部密度多不均匀,增强扫描呈肿瘤实质部明显强化,坏死区无强化。结论:胃肠道平滑肌肉瘤好发于胃及空肠,胃平滑肌肉瘤以腔内型居多;小肠平滑肌肉瘤以腔外型居多,综合应用消化道气钡双重造影检查、CT、B超检查及血管造影检查能提高胃肠平滑肌肉瘤的诊断水平。

Clinical and imaging diagnostic value of gastrointestinal leiomyosarcomas

Objective:To evaluate the clinical and imagine diagnosis features of gastrointestinal leiomyosarcomas.Methods:Retrospective analysis the genesis,size,modality of 46 cases of gastrointestinal leiomyosarcomas which were proved by histologically.Results:Undergoing X-ray there were gastric leiomyosarcomas(22 cases),intestinal leiomyosarcomas(23 cases),colonic leiomyosarcoma(1 case).There were 14 cases intraluminal of stomach,2 cases extraluminal of stomach,6 cases intra-and extra-luminal of stomach,19 cases extraluminal in intestine,2 cases intraluminal of intestine,and 2 cases intra-and extra-luminal of intestine,the sizes of lesions were between 6 and 10cm,and the margin of the tumor mass was multiloculated-shaped in 16 cases,There were ulcers in 22 cases;One case was intra-and extra-luminal of colonic leiomyosarcoma.The tumor mass were solid mass in B-mode ultrasonography,and irregular and multiloculated-shaped,inhomogeneous density,after injection of contrast media the density of essential part enhanced and the density of necrosis part unchanged in computed tomography.Conclusion:Gastrointestinal leiomyosarcomas were mainly occur in stomach and jejunum.The most part of gastric leiomyosarcomas were intraluminal,on the contrast,the most part of intestinal leiomyosarcomas were extraluminal.The combination of the X-ray barium radiography,computed tomography,B-mode ultrasonography can improve the diagnosis level of the gastrointestinal leiomyosarcomas.