高危险程度胃肠道间质瘤的CT表现

目的探讨高危险程度胃肠道间质瘤（HRGIST）的CT表现特征。方法回顾性分析2009年8月-2014年3月24例经手术病理证实的HRGIST的CT表现,并讨论其CT特征。结果肿瘤位于胃部12例,小肠11例（十二指肠/空肠/回肠=5/4/2）,直肠1例;肿块最大径2.5~15.0 cm,最大径〉5 cm者22例,〈5 cm者2例;24例中20例肿块形态不规则,21例周围脂肪间隙模糊;24例肿块均可见不同程度坏死囊变,15例溃疡形成,2例瘤体破溃穿孔,伴腹腔积液、积气,3例可见钙化。增强扫描大部分呈中度至明显不均匀强化,其中小肠HRGIST较胃HRGIST强化更明显,并可见丰富的血管供应;3例伴发肝脏多发转移。结论 HRGIST的CT表现有一定特征性,熟悉其影像学表现有助于对该病的诊断。

CT Features of High-risk Gastrointestinal Stromal Tumors

Objective To investigate the specific CT findings of high-risk gastrointestinal stromal tumors （GISTs）. Methods CT findings of 24 patients with high-risk GISTs from August 2009 to March 2014 proved by surgery and pathology were retrospectively reviewed. Results Twelve of the high-risk GISTs were from the stomach, 11 from the small intestine （5 from duodenum, 4 from jejunum, and 2 from ileum）, and 1 from the rectum. The biggest transverse diameter of the tumor was between 2.5 and 15.0 cm, and 2 were less than 5 cm and 22 of them were over 5 cm. The tumors appeared as irregular in 20 cases, and with indefinite boundary in 21 cases. Twenty-four tumors showed different levels of necrosis and cystic change, 15 showed ulcer, 2 showed perforation with effusion and pneumatosis, and 3 showed calcification. The enhancement of lesion was mostly moderately to markedly inhomogeneous. High-risk small intestinal stromal tumors had more significant enhancement and vessels. Hepatic metastasis in 3 cases was detected. Conclusion CT features of HRGISTs can be found with certain characteristics, which may contribute to the diagnosis.