胃肠间质瘤的多层螺旋CT表现

目的分析胃肠间质瘤（GIST）的多层螺旋CT表现及病理学表现,评价MSCT对该肿瘤的诊断价值。方法回顾性分析21例经病理证实的胃肠间质瘤的螺旋CT表现,将CT表现与生物学危险性进行对比研究。结果 21例GIST发生于胃12例,小肠7例,大肠2例。6例向腔内生长,15例腔外或同时向腔内外生长。8例肿瘤最长径≥50mm,13例肿瘤最长径〈50mm;14例边界清楚,7例边界不清;平扫密度均匀10例,不均匀11例;增强扫描动脉期轻中度强化18例,3例明显强化。高度危险4例,中度危险7例,低度危险8例,极低危险2例。结论 GIST的CT表现具有一定特征性,多层螺旋CT能准确诊断GIST,并判断其危险程度,对设计治疗方案及预后评估有重要价值,肿瘤最长径≥50mm、形状不规则、边界不清、密度不均匀、呈不均匀明显强化多为中、高度危险性;最长径〈50mm、形状规则、边界清楚、密度均匀、呈均匀强化的病灶多为中度以下危险性。

Imaging features of multi-spiral CT in gastrointestinal stromal tumors

Objective To evaluate the diagnostic value of MSCT through discussing the multi-slice spiral CT （MSCT） findings and pathologic features of GIST, and analyze their correlation. Methods Twenty one cases with GIST confirmed by pathology and immunohistochemistry were retrospectively analyzed. The CT features of GIST were compared with the pathologic findings. CT manifestation was also compared with the risk rank of tumor. Results In 21 cases, 12 lesions located in stomach, 7 cases located in small intestine, 2 cases located in colon. The tumor diameter in 13 cases was less than 5 cm, while that in 8 cases was more than 5 cm. 14 cases of the margins were well-defined, 7 cases were poorly-defined. Tumor density of 10 cases were homogeneous, 11 cases were not heterogeneous in plain scan. 18 cases showed mild to moderate enhancement in arterial phase of enhanced scan, 3 cases showed significant enhancement. 4 cases were high risk, 7 mid-range, 8 lower risk and 2 lowest risk. Conclusion The CT imaging of GIST has some characteristics, multislice CT can diagnose GIST accurately, and determine their degree of danger, which plays an important role in the design of treatment and prognosis. The tumors whose diamter more than 5 cm, irregular shape, fuzzy boundary, density nonheterogeneous, nonhomogenous enhancement mostly in mid-range and high risk. While the tumor whose diamter less than 5 cm, with regular shape, clear boundary, density heterogeneous,homogenous enhancement, mostly below mid-range risk.