Lin Yuan-Mao, Chiu Nai-Chi, Li Anna Fen-Yao, Liu Chien-An, Chou Yi-Hong, Chiou Yi-You
Yuan-Mao Lin, Nai-Chi Chiu, Chien-An Liu, Yi-Hong Chou, Yi-You Chiou, Division of Gastrointestinal Radiology, Department of Radiology, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
World J Gastroenterol. 2017 Apr 14;23(14):2493-2504. doi: 10.3748/wjg.v23.i14.2493.
Although gastric tumors have overlapping radiologic appearances, some unusual tumors may present specific imaging features. Using multidetector computed tomography (MDCT), with water as a negative oral contrast agent and intravenous contrast medium, can provide critical information for the diagnosis of gastric diseases. In addition, MDCT can evaluate the involvement of the gastric wall and extragastric extent of the disease, as compared with gastroenteroscopy and double-contrast upper gastrointestinal study. Regarding lesion location and size, enhancing and growth patterns, presence of calcification or fat, and involvement of the gastric wall and adjacent structures, CT may provide useful information. In this review article, we review the relevant literature and discuss the CT features and the histopathologic findings of different types of gastric lesions. The lesions are divided into benign (glomus tumors, schwannomas, leiomyomas, and lipomas), malignant (gastrointestinal stromal tumors, mucinous carcinomas, lymphomas, and carcinoid tumors), and tumor-like lesions (ectopic pancreas and bezoar). Familiarity with imaging appearances and pathologic findings can help physicians make an accurate diagnosis.
尽管胃肿瘤的放射学表现有重叠,但一些不常见的肿瘤可能呈现出特定的影像学特征。使用多排螺旋计算机断层扫描(MDCT),以水作为阴性口服对比剂并联合静脉造影剂,可为胃疾病的诊断提供关键信息。此外,与胃镜检查和双对比上消化道造影相比,MDCT能够评估胃壁受累情况以及疾病的胃外累及范围。关于病变的位置和大小、强化及生长方式、钙化或脂肪的存在情况以及胃壁和相邻结构的受累情况,CT可能提供有用信息。在这篇综述文章中,我们回顾相关文献并讨论不同类型胃病变的CT特征及组织病理学表现。这些病变分为良性(血管球瘤、神经鞘瘤、平滑肌瘤和脂肪瘤)、恶性(胃肠道间质瘤、黏液癌、淋巴瘤和类癌肿瘤)以及肿瘤样病变(异位胰腺和胃石)。熟悉影像学表现和病理学发现有助于医生做出准确诊断。