胃肠道间质瘤的CT表现及诊断价值

目的探讨胃肠道间质瘤的CT表现及临床诊断价值。方法回顾性分析经手术病理证实的31例胃肠道间质瘤CT表现。结果本组中胃间质瘤7例,小肠间质瘤16例,结肠间质瘤2例,直肠间质瘤1例,难以确定部位者5例。31例中良性3例,交界性6例,恶性22例。肿瘤呈类圆形或不规则形,密度均匀实性者6例,不均匀实性者14例,囊实性混合者11例,有2例有钙化灶。增强扫描有3例均匀强化,3例不均匀强化,内有斑点状变性坏死灶;25例呈不均匀明显强化,肿块内可见不同程度的变性、坏死区。3例良性者为均匀类圆形实性肿块,直径<5cm。交界性与恶性者形态、大小、密度等无明显差别,肿瘤直径均>5cm。结论对胃肠道间质瘤CT检查有助于发现肿块,定位准确,帮助判断肿瘤的良恶性程度。

CT Diagnosis of Gastrointestinal Stromal Tumors

Objective To investigate CT features of gastrointestinal stromal tumors(GISTs)and to evaluate CT value in the diagnosis of the disease.Methods CT findings in 31 cases with GIST proved pathologically were retrospectively analyzed.Results The tumors originated from the stomach(7 cases),small intestine(16 cases),colon(2 cases),rectum(1 case),ill-defined site(5 cases).Of these,3 cases were benign,6 cases were junctional and 22 cases were malignant.The lesions were oval or irregular in shape.The tumors appeared as homogeneous dense solid(6 cases),heterogeneous dense solid(14 cases),cystic and solid mixed(11 cases),2 cases with calcification.On enhanced CT scans,homogeneous enhancement was seen in 3 cases,heterogeneous enhancement with spot-like necrosis in 3 cases,and marked heterogeneous enhancement with different degree central necrosis in 25cases.The benign lesions of 3 cases were below 5cm in size with homogeneous density.No significant differences were seen between malignant and junctional lesions in form,size and density,the sizes of tumors were usually over 5cm.Conclusion CT can detect and precisely localize GISTs,and it is helpful in differentiation of benign or malignant GISTs.