胃肠道间质瘤的CT诊断

目的分析胃肠道间质瘤的CT表现，探讨CT对其诊断价值。方法回顾性分析我院经手术病理证实的33例胃肠道间质瘤患者的影像学资料，并将大体病理所见与CT表现相对照。结果发病部位：食管1例，胃19例，十二指肠6例，空肠4例，回肠2例，结肠1例。恶性21例，良性12例。CT表现为外生性或内生性肿块，最大径范围3-43cm，〈5cm者10例，≥5cm者23例，23例大于5cm肿瘤中19例为恶性间质瘤。21例恶性间质瘤中15例中心伴有坏死囊变；实性部分均表现为延迟强化。CT分型：粘膜下型15例，肌壁间型8例，浆膜下型10例。结论胃肠道间质瘤主要CT表现为圆形或类圆形软组织肿块，肿瘤与胃肠道相连部位以外的管壁结构保持正常，部分伴有囊变坏死，增强后呈现逐渐强化。CT能较高的检出胃肠道间质瘤。

CT Diagnosis of gastrointestinal stromal tumors

Objective To investigate the diagnostic value and appearances of CT in gastrointestinal stromal tumors （GIST）. Methods The CT imaging of 33 cases with GIST confirmed operatively and pathologically were reviewed retrospectively, The gross pathologic findings of the tumors were compared with the manifestations of CT study. Results In 33 cases, the lesion location was different： oesophagus（l case）, gastro （19 cases ）, duodenum （6 cases）, jejunum （4 cases）, ileum （2 cases）, colon （1 case）. 21 cases were malignant, and 12 cases benign. CT showed as exogenous or endogenous mass of 3 -43 cm, 10 cases with the diameter less than 5cm, 23 cases the greatest diameter over 5 cm, among of which 19 cases were malignant. In 21 cases with malignant tumors there had 15 cases which showed apparently cystic and necrosis.The tumors were cystic-solid with inhomogenous enhancement, the solid potion of tumors enhanced lightly to moderately and showed delayed reinforcement. CT type： submucosal was in 15 cases; muscle intramural 8 cases; and subserosa was in 10 cases. Conclusion The main CT findings of GIST is with round or roundish soft tissue mass.CT study is helpful for locating the tumor and observating the relationship of the tumor and surrounding structures. Apart form the wall mass linked all maintained normally, part of the tumor showed cystic and necrosis, after injection the contrast medium showed gradually enhancement. CT can precisely detect the GIST.