胃肠间质瘤的CT和内镜表现分析

目的：分析胃肠间质瘤（GIST）的CT、胃镜、超声胃镜及结肠镜表现。方法：选取我院2005年1月-2009年6月4年间经镜下活检手术病理证实为GIST的患者146，其中采用GEHispeedNX/Z双层螺旋CT检查126例，采用Olympus GIF-260胃镜检查93例，行PENTEXOF-13141超声胃镜检查66例，行Olympus CF-H260AT电子肠镜检查8例，所有病人术后进行免疫组化CD117和CD34检测。结果：146例均行手术病理及免疫组织化学法检查证实为间质瘤。其中病变位于胃93例，空肠20例，十二指肠15例，回肠10例，直肠5例，横结肠3例。CT确诊率为73.01%(92/126) ，CT影像表现为胃肠外的肿块或肠壁明显增厚，肿块大小密度不均匀，良性GIST密度均匀，坏死组织少，分叶不明显；恶性分叶明显，肿块都较大，呈不均匀强化。胃镜确诊率37.6%（35/93），结肠镜确诊率37.5%(3/8)，超声胃肠确诊率100%(66/66)。超声胃镜镜下所见肿物起源于粘膜肌层23例，固有肌层43例，均为低回声团块41例；内部回声不均匀，高回声14例，伴囊性变12例。结论：内镜联合CT检查可提高术前确诊率。超声胃镜对胃肠间质瘤诊断有重要意义。

Analysis of CT and Spiral Endoscopic Findings in Patients with Gastrointestinal Stromal Tumor

Objective: To study the findings of computed tomography(CT), gastroscope, endoscopic ultrasonograph (EUS) and colonoscope in patients with gastrointestinal stromal tumor (GIST). Methods: One hundred and forty-six cases with GIST, diagnosed by biopsy surgical pathology during January 2005 to June 2009, were included in this study. Among them, 126 cases were examined by GEHispeedNX/Z double spiral CT, 93 cases examined by Olympus GIF-260 gastroscope, 66 cases examined by PENTEXOF-13141 EUS and 8 cases examine...