目的：探讨胃血管球瘤的CT诊断价值，并对文献进行复习，以提高对其认识。方法：回顾性分析5例（女3例，男2例，年龄49~72岁，平均61岁）经手术病理证实的胃血管球瘤的CT特征（如病变部位、大小、CT值、强化曲线、供血动脉与引流静脉等表现）。采用CT平扫加动态增强，并进行MPR重建。结果：病灶均位于胃窦部，最大径1.8~3.2 cm，平均2.5 cm，病灶密度均匀或不均匀，未见出血、坏死及囊变。增强后动脉期呈明显均匀或不均匀强化，门脉期呈均匀强化，与腹主动脉强化曲线一致；肿瘤均可见供血动脉及引流静脉。结论：胃血管球瘤虽然相对少见， 但其具有血管性病变及供血动静脉伴行的影像学特点，CT动态增强对本病具有较高的诊断价值。
Abstract
Objective: To access the accuracy of CT in the diagnosis of gastric glomus and to discuss its value by reviewing the literature. Methods: A retrospective analysis of the CT characteristics of gastric glomus(such as tumor size, CT value, enhancement mode, feeding artery and draining vein, and so on) was done. The study included 5 cases of gastric glomus confirmed by surgery and pathology(3 females and 2 males, age range 49~72 years old, average age was 61 years old). Dynamic enhanced CT scanning and MPR was used. Results: All the lesions located in the gastric antrum(5 cases), with the diameter ranging from 1.8 to 3.2 cm, and the average size was 2.5 cm. The density of the lesions was uniform or not, without hemorrhage, necrosis or cystic changes. The enhancement of the tumors in arterial phase was obviously homogeneous or not, and they were homogeneously enhanced in portal vein phase, similar with the enhancement of the abdominal aorta. Also, feeding artery and draining vein were found in tumors. Conclusions: Although the gastric glomus tumor is relatively rare, it has certain imaging characteristics of vascular disease, with feeding arteries and companying veins. Dynamic enhanced CT has a high value in the diagnosis of the disease.
关键词
血管球瘤；胃肿瘤；体层摄影术 /
X线计算机
Key words
Glomus tumor /
Stomach neoplasms /
Tomography, X-ray computed
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参考文献
[1]Miettinen M, Paal E, Lasota J, et al. Gastrointestinal glomus tumors: a clinicopathologic, immunohistochemical, and molecular genetic study of 32 cases[J]. Am J Surg Pathol, 2002, 26(3): 301-311.
[2]程羽青，吴丽莉，金晓龙，等. 胃血管球瘤8例临床病理分析[J]. 诊断病理学杂志，2013，20（8）：462-465.
[3]陈洪潭，许国强，王丽君. 胃血管球瘤[J]. 中华医学杂志，2006，86（26）：1871-1872.
[4]Lee NK, Kim S, Kim GH, et al. Hypervascular subepithelial gastrointestinal masses: CT-pathologic correlation[J]. Radio Graphics, 2010, 30(7): 1915-1934.
[5]陶昀璐，王振军，韩加刚，等. 胃血管球瘤43例诊治分析[J]. 现代肿瘤医学，2013，21（5）：1097-1100.
[6]Lee HW, Lee JJ, Yang DH, et al. A clinicopathologic study of glomus tumor of the stomach[J]. J Clin Gastroenterol, 2006, 40(8): 717-720.
[7]Haque S, Modlin IM, West AB. Multiple glomus tumors of the stomach with intravascular spread[J]. Am J Surg Pathol, 1992, 16(3): 291-299.
[8]Folpe AL, Fanburg-Smith JC, Miettinen M, et al. Atypical and malignant glomus tumors: analysis of 52 cases, with a proposal for the reclassification of glomus tumors[J]. Am J Surg Pathol, 2001, 25(1): 1-12.
[9]Warner KE, Haidak GL. Massiveglomus tumor of the stomach: 20-year follow-up and autopsy findings[J]. Am J Gastroenterol, 1984, 79(4): 253-255.
[10]高峰，李文惠，李发智，等. 胃壁浆肌层巨大血管球瘤一例[J]. 中华普通外科杂志，2000，15（10）：616.
[11]Kim JK, Won JH, Cho YK, et al. Glomus tumor of the stomach: CT findings[J]. Abdom Imaging, 2001, 26(3): 303-305.
[12]孔凡彬，曹伟，张春宁. 胃血管球瘤的CT诊断（附3例报告）[J]. 医学影像学杂志，2008，18（12）：1467-1468.
[13]应明亮，肖文波，许顺良，等. 胃肠道外间质瘤的CT诊断价值[J]. 临床放射学杂志，2012，31（5）：673-676.
[14]刘玉，林晓珠，宋琦，等. 胃血管球瘤CT诊断二例[J]. 放射学实践，2012，25（2）：237-238.
[15]文亮，韩丹. 胃肠道类癌的临床病理及其影像学表现[J]. 临床放射学杂志，2008，27（5）：694-697.
