胃肠道间质瘤的MRI征象与不同危险度的相关性

目的:分析胃肠道间质瘤(gastrointestinal stromal tumors,GISTs)MRI征象,探讨不同MRI征象与其危险度间的相关性。方法:回顾性分析2007年9月至2017年12月天津医科大学肿瘤医院54例经手术病理证实为GISTs患者的临床病理资料,分析GISTs的MRI征象中的大小、部位、形态、边界、生长方式、有无囊变坏死、转移、信号均匀性、肿瘤时间-信号强化曲线及扩散加权成像(DWI)上表观扩散系数(ADC)值(平均ADC值),并将上述MRI征象与GISTs侵袭性进行相关性分析。结果:54例患者中,低危险度16例,中危险度13例,高危险度25例。统计结果显示肿瘤大小、部位、形态、边界、有无囊变坏死、信号均匀性及ADC值在预测GISTs侵袭性中差异具有统计学意义(P<0.05)。肿瘤生长方式、有无转移及强化曲线与GISTs的侵袭性差异无统计学意义(P>0.05)。随着GISTs危险度增高,肿瘤体积增大、形态不规则、边界不清,肿瘤内部信号不均,更易发生囊变坏死,ADC值越低。结论:MRI不同征象可以对GISTs的侵袭性进行术前初步评价,为临床治疗及预后提供参考。

Correlation between MRI features and tumor risk grade in gastrointestinal stromal tumors

  Objective  To investigate the correlation between magnetic resonance imaging (MRI) features and tumor risk grade of gastrointestinal stromal tumors (GISTs).  Methods  Between September 2007 to December 2017, 54 patients who underwent MRI and were pathologically diagnosed in Tianjin Medical University Cancer Institute and Hospital were retrospectively reviewed.We analyzed MRI features including the size, location, shape, boundary, and growth pattern of the tumor; cystic necrosis; metastasis; T1WI and T2WI signal intensities; enhancement signal intensity-time (SIT) curve pattern; and average apparent diffusion coefficient (ADC) values.The MRI features were compared with the tumor risk grade.  Results  Of the 54 cases, 16 were of low-risk grade, 13 were of intermediate-risk grade, and 25 were of high-risk grade.Statistical analysis showed that tumor size, location, shape, boundary, cystic necrosis, signal intensity, and average ADC values were correlated with tumor risk grade (P< 0.05).However, tumor growth pattern, metastasis, and enhancement SIT curve pattern were not correlated with tumor risk grade (P>0.05).GISTs with higher aggressive features were more likely to have larger size, irregular shape, unclear boundary, cystic necrosis, heterogeneous signal intensity, and lower ADC values on MRI.  Conclusions  MRI has the potential to predict the risk grade of GISTs before surgery, thereby guiding clinical management, and evaluating prognosis.