老年性胃间质瘤的螺旋CT表现及其病理基础

目的探讨老年性胃间质瘤的螺旋CT表现，以提高对该病的认识。方法收集资料完整的老年性胃间质瘤47例，分析其螺旋CT表现及病理基础。结果良性11例，交界性9例，恶性27例；腔内型5例，腔外型30例，腔内外型12例。良性、交界肿瘤CT平扫呈圆形或类圆形均匀密度软组织肿块，肿瘤直径常小于5cm，增强扫描病灶呈中度以上的较均匀强化；恶性病变CT平扫为较大的不规则或分叶状肿块，其内有出血、坏死、囊变及钙化，增强扫描肿物呈不均匀强化，其内坏死、囊变区无强化，动脉期瘤体旁可见排列成簇状或线状增强的细小血管，静脉期病变强化程度高于动脉期。结合手术病理，CT对病变定位准确率为100％，定性准确率达91％。结论螺旋CT能很好反映老年性胃间质瘤的生长方式及病理基础，存肿瘤的检出、判断肿瘤与周围器官的关系、有无转移及良恶性鉴别等方面均有重要价值。

Gastric stromal tumor: spiral CT findings with pathologic correlation in the elderly patients

Objective To explore the spiral CT （SCT） findings of gastric stromal tumors in order to improve the accuracy of the CT diagnosis. Methods CT imaging features and pathologic characteristic of the clinical symptoms of the 47 patients with gastric stromal tumors were analyzed and compared. Results 11 cases with benign tumors, 9 cases with borderline tumors and 27 cases with malignant tumors were found, which included 5 cases with endo-luminal growth, 30 cases with extraluminal growth and 12 cases duplex growth. The benign and borderline lesions were usually below 5 cm in size with well defined margin, homogeneous density and displayed moderate enhancement. The malignant lesions were over 5 cm in size with ill defined, necrosis or cysts formation and calcification within the tumors and displayed inhomogeneous enhancement. Small vessels arranged in clumps or in line around the tumor during the arterial phase. The enhanced extent of venous phase was more obvious than that of arterial phase. The accurate rate of localization was 100% and the qualitative diagnosis was 91% via the surgical-pathological analysis. Conclusions The CT imaging features of gastric stromal tumor are corresponded well with pathologic findings. CT plays an important role in tumor detection, evaluation of the relationships between tumor and surrounding organs, metastasis and qualitative diagnosis of gastric stromal tumor.