64层螺旋CT在胃肠道间质瘤诊断中的应用

目的:探讨胃肠道间质瘤(GIST)的64层螺旋CT表现及诊断价值.方法:回顾性分析经手术病理证实的22例GIST患者影像资料,并与临床及病理表现对照.6例患者先行消化道钡餐检查,所有患者均行64层螺旋CT平扫及双期增强扫描.结果:22例胃肠道间质瘤中位于胃11例,十二指肠1例,空肠4例,回肠4例,腹腔网膜2例.腔外型生长者6例,腔内生长2例,腔内外生长者12例,2例系膜来源间质瘤.肿瘤直径2.5～16cm不等,肿瘤大于5.0cm者多有中心或偏侧坏死区,且与周围组织境界不清时考虑肿瘤恶变.多数病灶增强动脉期明显不均匀强化,静脉期呈持续明显强化.22例中5例恶性,其中2例伴肝转移,1例伴有肺转移.结论:64层螺旋CT可以很好的显示胃肠道间质瘤的部位、大小、形态及内部结构,其CT动态增强检查结合后处理重建功能在GIST的定位、定性诊断及对临床治疗指导中有重要价值.

Application of 64-slice spiral CT in the diagnosis of gastrointestinal stromal tumors

Objective： To investigate the manifestation and its value of 64-slice spiral CT in the diagnosis of gastrointestinal stromal tumors（GIST）.Methods： CT imaging data of 22 patients with GIST confirmed by surgery and pathology were retrospectively analysed and compared with the clinic presentations and pathological findings.In this work,6 patients were subjected to gastrointestinal barium meal examination and all patients underwent plain and enhanced dual-phase scan. Results：Of these 22 patients,11 were located in stomach,1 in duodenum,4 in jejunum,4 in ileum,2 in small mesentery.As for the growth pattern,these GIST patients were divided into intraluminal type（2 cases）,extraluminal type（6 cases） and mixed type（12 cases）,and mesangial origin（2 cases）.Tumor diameters ranged from 2.5 to 16 cm.Tumors more than 5 cm in diameters were apt to present central or unilateral necrosis.Most of the lesions were showed uneven enhancement in the arterial phase and the tumors were continued to strengthen in venous phase.In this series,5 patients were malignant,in whom 2 patients occurred liver metastasis,1 pateint lung metastasis at the same time. Conclusion： GISTs have a certain performance on 64-slice spiral CT.64-slice spiral CT examination combined with dynamic contrast-enhanced post-processing functions can provide an important value for the location and qualitative diagnosis as well as clinical treatment of this disorder.