胃肠道间质瘤的CT表现及诊断

目的:探讨胃肠道间质瘤(GIST)的CT表现、诊断及其价值。方法:回顾性分析我院34例经病理及免疫组织化学证实的GIST的影像学资料,全部病例均行CT检查,其中28例注射静脉对比剂后行增强扫描;5例胃双重造影及全消化道钡餐;7例内镜检查;19例超声检查。结果:本组34例病例中67.6%(23/34)经诊断为恶性,29.4%(10/34)为良性,2.9%(1/34)诊断为交界性。CT主要表现为:88.2%(30/34)为实性肿块,其中26.6%(8/30)为均匀密度,73.3%(22/30)为不均匀密度;11.8%(4/30)为囊性肿块,直径3-20cm,其中50%(2/4)可见坏死液化灶;34例肿块中55.9%(19/34)与邻近结构有明显的粘连或直接侵犯周围组织,其中10.5%(2/19)肿块边缘可见条带状钙化;增强扫描病灶呈不均与明显强化。本组病例肝转移5.9%(2/34),腹膜转移2.9%(1/34),膀胱转移2.9%(1/34)。结论:CT检查可定位诊断,并有助于定性诊断。

CT Imaging of Gastrointestinal Stromal Tumors

Objective:To analyze the CT imaging of gastrointestinal stromal tumors (GIST) and its diagnostic value. Methods:The clinical and CT scan data of 34 patients with GIST proved by operation and pathology were reviewed. All the patients were examined by CT scan and 28 of them also examined with contrast-enhanced CT scan,5 patients took the gastrointestinal barium examination,7 patients had gastrointestinal endoscopy,and 19 patients underwent ultrasonic scan. Results:67.6% (23/34) of the patients were diagnosed as malignant GIST,29.4% (10/34) were benign,and 2.9% (1/34) was potentially malignant. CT scan mainly showed 88.2% (30/34) of the tumors were solid,among which 26.6% (8/30) had homogeneous density,and 73.3% (22/30) had inhomogeneous density; 11.8% (4/30) were cystic with diameters of 3-20 cm,including 2 cases showed necrosis within the cystic mass; 55.9% (19/34) had obvious adhesions or directly involved with around tissue,and 10.5% of them (2/19) calcified focus in their margins; the mass were mainly asymmetrical and obviously enhanced by contrast-enhanced CT scan. 5.9% (2/34) of the patients had metastasis in liver,2.9% (1/34) in peritoneum and 2.9 % (1/34) in bladder. Conclusion:CT is valuable in locating the tumor,and also helpful in differentiating benign from malignant of GIST.