胃肠道间质瘤的多层螺旋CT诊断

目的探讨胃肠道间质瘤(GIST)的影像学表现特点。方法回顾性分析经手术病理证实的37例GIST的16层螺旋CT表现,全部病例均行CT平扫和增强扫描。结果 37例GIST中发生于胃23例,小肠8例,结肠3例,肠系膜3例。位于消化道的34例中,瘤体位于消化道腔外27例,腔内、外混合生长7例。CT表现:肿块密度均匀5例,不均匀32例,增强后均匀强化4例,不均匀强化33例,动脉期肿块实性部分轻中度强化,静脉期强化较动脉期更明显,呈中度或明显强化。结论胃肠道间质瘤CT主要表现为胃肠道腔外生长为主的软组织肿块,易囊变坏死,增强后动脉期肿块实性部分强化,静脉期强化较动脉期更明显,以肝脏和系膜转移较为常见,淋巴结转移、腹腔积液及肠梗阻较为少见。

MSCT diagnosis of gastrointestinal stromal tumor

Objective To investigate MSCT features of gastrointestinal stromal tumor（GIST）. Methods CT findings of 37 cases with GISTs confirmed by pathology were retrospectively analyzed. All cases were examed by CT plain and enhanced. Results The tumors were of gastric（n=23）, small intestine（n=8）, colonic（n=3）, mesenteric（n=3）. There were 27 exophytic growth tumors and 7 introphytie growth tumors of 34 gastrointestinal tract origin tumors.On CT examinations,5 tumors appeared as homogenous density and 32 tumors as heterogenous density.4 tumors demon- strated homogeneous enhancement,while the remaining 33 tumors showed heterogeneous enhancement.The tumors were cystic-solid with inhomogenous attenuation,the solid position of tumors were enhanced slightly and moderately in artery phase with marked enhancement in portal venous and delayed phase. Conclusion The CT findings of GIST should be considered for an exophytic growth, gastrointestinal soft tissue tumor with cystic change,necrosis and heterogeneous enhancement. The solid position of tumors were enhanced in artery phase with marked enhancement in portal venous and delayed phase.Liver and mesangium transfer was common, lymph node metastasis, ascites and obstruction were rare.