多层螺旋CT对胃肠道外间质瘤的诊断价值

目的:采用64层螺旋CT三期增强扫描和三维重建技术,对胃肠道外间质瘤的CT表现进行分析,以提高对该病的影像诊断水平。方法:回顾性分析经手术或穿刺活检证实的13例腹腔内胃肠道外间质瘤患者的影像资料,观察指标有:病灶数目、部位、形态、边缘、大小、平扫密度及三期增强情况、病灶生长方式及其与邻近血管或器官的关系。结果:本组13例患者全为单发病灶,其中发生于肠系膜有7例、发生于网膜有4例、发生于腹膜后间隙有2例。病灶多为圆形、类圆形或轻度分叶,少数呈不规则形。病灶最大直径约为5.5～14.5 cm。平扫病灶均呈密度欠均匀的软组织肿块影;三期增强扫描均呈不均匀强化,囊变或坏死部分无强化。所有病灶境界清楚,病灶周围器官、血管受压推移。有1例肝脏多发转移。结论:胃肠外间质瘤的多层螺旋CT表现具有一定的特征,结合三维重建技术对胃肠道外间质瘤的定位和定性诊断具有较高的临床价值。

Diagnosis evaluation of multi-slice spiral CT in gastrointestinal stromal tumors

Objective:The three phases enhanced scanning with 64-slice spiral CT and three-dimensional reconstruction technology have been adopted.Analysis the CT findings of extragastrointestinal stromal tumors to improve the diagnostic level of the disease.Methods:Retrospective analyze 13 cases of intraperitoneal extragastrointestinal stromal tumor imaging data confirmed by operation or biopsy.The observation indexes include: the numbers,position,shape,the edge and size of lesions,plain scanning density and three phases enhanced condition,the mode of growth,the relationship between lesions and adjacent vessels or organs.Results:13 cases are all single lesions,among which 7 cases are found in mesentery,4 cases in omentum and 2 cases in the retroperitoneal space.Lesions were round,oval or slightly lobulated.Some of them were irregular in shape.The maximum diameter of lesions ranged from 5.5 to 14.5 cm.Plain scanning lesions showed homogeneous density in soft tissue mass;the three phases enhanced scanning showed homogeneous enhancement.The cystic or necrotic part present no enhancement.All of the lesions were clear in boundary.The surrounding organs and vessels are pressed and pushed.There was 1 case of liver metastasis.Conclusion:There are certain features of multi-slice spiral CT manifestations of extragastrointestinal stromal tumors.The three-dimensional reconstruction technique shows high clinical value in the positioning and qualitative diagnosis of gastrointestinal stromal tumor.