多层螺旋CT对腹内胃肠道外间质瘤的诊断价值

目的探讨多层螺旋CT（MSCT）对腹内胃肠道外间质瘤（EGIST）的诊断价值。方法回顾性分析经手术病理证实的16例EGIST的临床资料﹑MSCT表现并与其危险度进行对比分析。结果肿瘤原发于肠系膜6例,网膜4例,腹膜2例,腹膜后2例,腹膜及肠系膜1例,盆腔（直肠阴道间）1例,单发1例,多发5例,肿块最大直径20 cm,最小直径4.3 cm,平均直径10.2 cm。CT平扫肿块呈类圆形或分叶状。2例密度均匀,2例密度不均匀,其中1例斑点状强化,5例肿瘤内单发片状低密度,7例多发不规则低密度,肿瘤实性部分CT值29~45 HU。增强后肿块较均匀或不均匀强化,动脉期轻~中度强化,静脉期持续强化,CT值较动脉期增加5~12 HU,延迟期强化幅度略有下降。2例动脉期肿瘤内可见紊乱条状强化的血管影。结论 MSCT对EGIST的诊断有一定特点,通过观察病灶数目、大小、形态、密度及有无转移,可为预判肿瘤危险度提供一定有价值信息。

Diagnostic value on MSCT in exter-gastrointestinal stromal tumors

Objective To discuss the diagnostic value of multislice spiral CT(MSCT) in exter-gastrointestinal stromal tumors(EGIST).Methods The clinical data,CT features of 19 patients with GIST confirmed by operation and pathology were analyzed retrospectively.Results The locations of tumor were mesenterium in 6 cases,omenta in 4 cases,peritoneum in 2 cases,post-peritoneum in 2 cases,peritoneum and mesentery in 1 case,pelvic cavity in 1 case,single lesion was found in 1 case and multiple lesions were found in 5 cases.The diameter of tumor ranged from 4.3 cm to 20.0 cm,the average diameter was 10.2 cm.The plain CT showed a similar rounded or lobulated tumors,2 cases density were uniform,2 cases density were uneven,the tumors center of 5 cases had low density areas,7 cases had irregular low density areas,The CT value of solid part were 29-45 HU.Homogeneous or inhomogeneous enhancement after enhancement,light to medium enhancement in the arterial phase,then continuously enhanced in the vein phase,the CT value increased 5-12 HU,The CT value decreased a little in the delayed phase,2 cases could see the disorderly image of the blood vessel.Conclusion EGIST has some MSCT features which are helpful for diagnosis.It can provide useful information based on the number,size,shape,density,and metastasis,It can provide the useful information to distinguish the dangerous of tumour.