早期胃间质瘤的MSCT诊断与手术病理对照分析

【目的】分析早期胃间质瘤（GIST）的16层螺旋CT表现,提高对GIST的早期影像诊断率。【方法】对17例经手术病理证实的直径小于5cm的GIST多排螺旋CT资料进行回顾性分析,对肿瘤部位、形态、增强特点与病理诊断对照总结（所有病例均行多平面重建、容积再现和最大密度投影等）。【结果】17例GIST患者中,局限于胃壁1例;向胃腔外生长5例;向胃腔内生长11例。肿块呈类圆形或分叶状,密度多不均匀,恶性程度较高肿瘤强化不规则,边缘强化更明显。【结论】多排螺旋CT对早期GIST有较高检出率,特别是多排螺旋CT多方位重建图像能更详尽展现病变形态、密度、累及范围及与周围器官关系;动态增强扫描反映肿瘤血供情况和强化规律,对病变定性诊断提供较大帮助。

Contrast Analysis of MSCT and Surgical Pathology in the Diagnosis of Early Gastric Stromal Tumor

[Objective] To analyze the 16-slice spiral-CT findings in early gastric stromal tumors（GIST） and improve its imaging diagnosis rate. [Methods]The MSCT data of 17 GIST patients（less than 5 cm in diameter） confirmed by pathology were analyzed retrospectively. Tumor location, shape, enhancement features and pathologic diag nosis were summarized. Multi-planar reconstruction, volume rendering and maximum intensity projection were performed in all patients. [Results] Of 17 GIST patients, the tumor was limited to stomach wall in 1 case, and grew up out of gastric cavity in 5 cases and into gastric cavity in 11 cases. The tumor mainly was round-like or lobulated and uneven of density. High malignant tumor showed irregular enhancement and obvious enhancement of the edge. [Con- clusion] 16-Slice CT findings have a higher detection rate in early gastric stromal tumors. Especially multi-dimensional reconstruction of MSCT images can fully reveal the shape, density, involved range of the lesion and its relationship with the surrounding organs. Dynamic enhancement scanning can show tumor blood supply and enhancement rule, so it is more helpful for the qualitative diagnosis of the disease.