胃肠道间质瘤的影像学表现

目的探讨胃肠道间质瘤(GIST)的影像学表现特点及其诊断价值。方法回顾分析41例经手术和病理证实的胃肠道间质瘤影像及临床资料。结果病灶位于胃20例,小肠5例,直肠3例,食管2例,消化道外11例。影像学检查恶性GIST共计27例,其中21例肿瘤直径>5cm,边界不清楚,19例与邻近结构有明显的粘连或直接侵犯周围组织,13例可见明显瘤内坏死、囊变,5例出现转移灶;良性14例,11例肿瘤直径<5cm,边界清楚,密度均匀,增强后均匀强化。结论胃肠道双对比造影检查易于发现腔内型和腔内外型胃肠道间质瘤。CT检查弥补了常规胃肠道造影和内窥镜检查的不足,对GIST的准确定位、良恶性的判断、指导临床治疗和估计预后有重要价值。

Imaging Findings of Gastrointestinal Stromal Tumors

Objective To investigate the imaging features of gastrointestinal stromal tumors (GIST) and its diagnostic value. Methods The clinical and imaging data of 41 patients with GIST proved by operation and pathology were analysed. Results Tumors located in the stomach in 20 cases, small bowel in 5 cases, rectum in 3 cases, esophagus in 2 cases and extra gastrointestinal sites in 11 cases. There were 27 malignant GIST diagnosed by imageologic examination,of them, 21 mass exceeded 5 cm in diameter, margins were vague, 19 cases had obvious adhesion or directly involved with around tissue,13 cases with obvious necrosis and cystic changes within the mass. 5 cases with metastase focus.Benign GIST in 14 cases, 11 cases were less than 5 cm in diameter, most of them had smooth margin,homogeneous density and symmetrical enhancement effect.Conclusion X-ray gastrointestinal double contrast radiography examination finds easily inside antrum and inside-and-outside antrum type GIST; CT examination offsets deficiency of general gastrointestinal radiography. It is valuable in localizing precisely, judging benign and malignantin, guiding clinical therapy and estimating prognosis for GIST.