胃肠道间质瘤的CT诊断价值

目的分析胃肠道间质瘤(GIST)的CT表现特点,探讨CT对该肿瘤的诊断价值。方法回顾性分析经手术病理证实的GIST32例,术前均行CT平扫和增强扫描,15例行胃肠道气钡双重造影检查。结果肿瘤发生于胃18例,空肠4例,回肠3例,食管和肠系膜各2例,升结肠、直肠和大网膜各1例。32例CIST中,良性12例,肿瘤直径≤5.0cm,边界清楚,密度均匀;恶性20例,肿块直径≥7cm,肿瘤边缘有分叶,肿块内有坏死,肿瘤的溃疡大而深,周围组织侵犯或远处转移。本组CT定位准确度为96.9%(31/32),CT判断恶性准确度为93.8%(30/32)。结论CT对GIST具有较高的诊断价值,可弥补X线钡餐造影的局限性,对临床早期诊断和治疗以及评价预后具有重要价值。

CT Diagnostic Value of Gastrointestinal Stromal Tumors

Objective To analyze CT features of gastrointestinal stromal tumors(GIST) and to evaluate its value in diagnosis of thedisease.Methods Both plain and enhanced CT findings in 32 cases with GIST pathologically-proved were retrospectively analyzed.Gastrointestinal air-barium double contrast radiography was performed in 15 patients . Results The tumors originated from the stomach (n=18),jejunum(n=4),ileum(n=3),esophagus(n=2),mesentery(n=2),ascending colon(n=1),rectum(n=1) and greater omentum(n=1).Of 32 GIST,12 were benign and 20 were malignant.In benign GIST ,the diameter of the tumor was less than 5cm,with clear margin and homogeneous density.In malignant GIST,the diameter of the tumor was more than 7 cm,the tumors were lobular in shape ,with necrosis within the tumor ,the tumor had large and deep ulcers,invasion of adjacent tissues and metastasis.The positive predictive value of CT for location of GTST was 96.9%(31/32),the positive predictive value of CT for differentiation of benign and malignant GIST was 93.8%(30/32).Conclusion CT is of great value in diagnosis of GIST.It can be considered as a supplement to X-ray barium meal examination and can provide useful informations for early diagnosis and for the evaluation of the treatment and prognosis.