| 周爱平,王春,于骞.直肠间质瘤的MRI表现及临床分析[J].浙江中西医结合杂志,2021,31(1): |
| 直肠间质瘤的MRI表现及临床分析 |
| MRI manifestations and clinical analysis for rectal stromal tumors |
| 投稿时间：2020-05-15 修订日期：2020-11-28 |
| DOI： |
| 中文关键词: 直肠 间质瘤 核磁共振 诊断 治疗 |
| 英文关键词:Rectum Stromal tumor MRI Diagnosis Treatment |
| 基金项目: |
|
| 摘要点击次数: 336 |
| 全文下载次数: 1 |
| 中文摘要: |
| 目的 探讨直肠间质瘤的MRI表现及临床特征。方法 回顾性分析9例经病理学证实直肠间质瘤的MRI及临床资料。结果 临床8例出现下腹部胀痛不适，1例无明显症状。肿瘤位于直肠上段1例、中段及下段5例、下段3例，最大直径约2.7~8.3cm，平均(6.3±1.6)cm。7例肿瘤肠腔外生长、2例腔内、外生长。MR平扫9例T1WI为等及较低信号，T2WI上8例稍高信号、1例高信号；DWI均为高信号；动态增强扫描9例均持续明显强化，内部均见无强化坏死区，8例见强化假包膜；5例见直肠缘滋养血管，1例导致直肠不全梗阻，3例出现肝脏单发转移，9例均未见腹、盆腔积液及淋巴结转移。9例均经手术根治性切除，其中8例中、高度危险性肿瘤术后行伊马替尼辅助治疗。术后随访6~71个月，3例因肿瘤广泛转移死亡，其余6例未见复发及转移。结论 直肠间质瘤缺乏特殊临床症状；MRI对其诊断具有较大价值，多表现为肠壁外生性肿块，平扫T2WI呈高或稍高信号，DWI高信号，动态增强扫描持续中度以上明显强化，呈“快进慢出”的强化模式，假包膜常见，较大肿瘤可见坏死、囊变，容易发生种植转移和血行转移，但淋巴结转移少见；早期根治性切除可以改善预后。 |
| 英文摘要: |
| Objective To explore the MRI manifestations and clinical features of rectal stromal tumors. Methods The MRI and clinical data of 9 cases of rectal stromal tumor confirmed by pathology were analyzed retrospectively. Results Clinically, 8 cases showed lower abdominal distention and discomfort, 1 case had no obvious symptoms. 1 tumor located in the upper segment of rectum,5 tumors located in the middle to lower segment and 3 tumors located in the lower segment. The maximum diameter of the tumors was about 2.7~8.3cm, with an mean value of (6.3±1.6)cm. 7 cases grew outside of the lumen and 2 cases grew inside and outside of the lumen. On unenhanced MRI, 9 cases showed equal and low signal on T1WI, 8 cases showed slightly high signal and 1 case showed high signal on T2WI. All 9 cases showed high signal on DWI. On dynamic enhanced MRI, all 9 cases showed continuous and obvious enhancement,and necrotic area wothout enhancement were observed, pseudocapsule with obvious enhancement were observed in 8 tumors.Incomplete obstruction of rectum occured in 1 case, nutrient vessels of rectum margin were observed in 5 cases, and single metastasis of liver occured in 3 cases. Abdominal and pelvic effusion and lymph node metastasis can not be observed in 9 cases. All 9 cases were treated by radical resection, and 8 cases accepted adjuvant therapy of Imatinib. 9 cases were followed -up for 6~71 months, 3 cases died of extensive metastasis of GIST, and recur or metastasize was not occured in the rest 6 cases. Conclusion Rectal stromal tumors lack special clinical symptoms,MRI show important value for the diagnosis, most tumors show mass outside the intestinal wall, T2WI show high or slightly high signal and DWI show high signal;On dynamic contrast-enhanced MRI,most tumors show continuous moderate or above obvious enhancement, with a "fast in slow out" enhanced mode, pseudocapsule, necrosis and cystic change can be observed in large tumors, implant metastasis and hematogenous metastasis are usual while lymph node metastasis is rare; early radical resection can improve the prognosis. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
