胃肠道间质瘤的CT诊断探讨

目的分析胃肠道间质瘤的CT特点,探讨其诊断价值。方法回顾分析30例经手术病理证实的胃肠道间质瘤的CT资料。结果发生于胃部15例,小肠14例,结肠1例,CT平扫肿块呈软组织密度均匀者10例,瘤内有低密度坏死者15例,肿块内有钙化者3例,边缘清晰者22例,病灶多呈圆形或半圆形,增强扫描肿瘤实质明显强化,CT值在40-100HU,内部坏死囊变区无强化;良性10例,恶性20例,良性肿块直径小于5cm10例(10/10),恶性肿块直径大于5cm16例(16/20)。结论CT是诊断胃肠道间质瘤的主要手段,CT表现有一定的特征,在诊断和鉴别良、恶性上有更大优势,对于指导临床治疗和估计预后有一定价值。

CT finding and diagnosic of gastrointestinal stromal tumor

Objective Toanalyze CT fetures of gastrointestinal stromal tumors（GIST） and to evaluate CT in the diagnosis of the disease. Materials and Methods CT findings were retrospectively analyzed in 30 cases with surgically and pathologically proved GIST. Results Among the 30 cases,15 masses were located in stomach,14 in small intestine and in rectum.On non-contrast enhanced CT scan,the density of masses is equal to that of softtissue.The lesions were homogenous in 10 cases;hypo-dense necrosis was found within the lesions in 15 cases;calcification was revealed in 3 cases;and well demarcated lesions were demonstrated in 22 cases;tbe lesions were mainly round or oval in shape.In contrast enhanced scan,remarkable enhancement was seen in the parenchyma of the tumor,CT value increased from 40-100Hu,while no enhancement was revealed in the necrosis and cystic area of the tumor.Ten cases out of 30 had been diagnosed as benign GIST, while malignant GIST was determined in the other 20 eases.The diameter of all benign masses was less than 5cm in 10 cases（10/10）,the diameter of malignant masses was more than 5cm in 16 cases（16/20）. Conclusion CT were of the main methods in the diagnosis of gastrointestinal stromal tumors.There are characteristic CT manifestations of GISI,CT was of great advantage in the diagnosis and differential diagnosis between benign and malignant tumors,and in instructing clinical treatment and estimating prognosis.