胃间质瘤的影像学检查评价

目的探讨胃间质瘤的影像诊断价值。方法搜集经手术及病理证实的胃间质瘤20例进行回顾性分析。结果良性7例,恶性13例。发生于胃体9例,胃底8例,胃窦3例。病灶呈类圆形17例,不规则形3例,最大径1~18 cm,平均6.4 cm。良性7例,最大径1~4.2 cm,恶性或潜在恶性13例,最大径2.8~18 cm。GI显示腔内充盈缺损,粘膜推移变平,并可见龛影。CT平扫肿块密度不均匀,增强呈中度不均匀强化,静脉期明显。胃镜示粘膜隆起性病变,可见溃疡。EUS表现为起源于固有肌层的低回声团块。结论EUS是诊断胃间质瘤的最准确方法。多种影像学检查相结合,有助于胃间质瘤的定位和良恶性判断。

Evaluation of imaging method in the diagnosis of gastric stromal tumors

Aim To evaluate the radiological diagnosis in gastric stromal tumors(GST).Methed The clinical and radiological data of 20 cases with GSTs were analyzed retrospectively.All cases were proved by operation and pathology.Results 7 cases were benign and 13 cases were malignant.The tumors were located in corpus gastricus in 9 cases,cardiac portion in 8 cases,sinus ventricul in 3 cases.Round mass was found in 17 cases,while the mass was lobulated in the rest 3 cases.The diameter of the tumors was 1~18 cm,6.4 cm in average.GI examination showed filling defect mass press in the stomach cavity,the local mucosal was destroyed.CT scan showed tumors in-homogenous in density or intensity and moderate enhancement.Fiberoptic endoscopy scan showed the case of protuberent lesions in upper digestive tract,and ulcer could be found.EUS showed the low level echo tumors originated from tunica muscularis.Conclusion EUS is the most accurate method in the diagnosis of GST.Integrating various imaging modalities is helpful to make diagnosis on both the location and the nature of the GST.