胃间质瘤的多排螺旋CT诊断及病理对照

目的:提高对胃间质瘤(GST)影像征象的认识,评价多排CT(MSCT)检查的价值。方法:回顾性分析经手术病理证实的17例GST病例的临床及CT影像资料。结果:病变向腔内生长4例,向腔外生长6例,向腔内外同时生长7例。CT平扫呈均匀或不均匀软组织肿块,其内可出现坏死、囊性变及钙化。增强扫描时病灶有不同程度强化,动脉期瘤体旁可见排列成簇状或线状增强的细小血管,静脉期病变强化程度高于动脉期。所有病例MSCT扫描未发现病灶邻近的胃壁增厚。结合手术病理,病变定位准确率为76.5%(13/17)。结论:外生性或腔内外生长肿块、邻近胃壁不增厚是GST的特征性CT表现,增强扫描静脉期病变强化程度高于动脉期也是本病的特点。MSCT的重建能明确病变部位、内部结构及与周围组织的关系,为手术提供重要参考。

Multi-spiral CT in the diagnosis of gastric stromal tumors and correlation with pathology

Objective: To improve imaging recognition of gastric stromal tumors(GST) and appreciate the value of multi-spiral CT(MSCT) scan. Methods: The clinical and imaging data of 17 cases with GST proved by pathology were reviewed retrospectively. Results: The lesions included endo-luminal growth in 4 cases, extra-luminal growth in 6 cases and duplex-growth in 7 cases. MSCT showed homogeneous or inhomogeneous density, which associated with necrosis, cystis formation and calcification. In enhanced cases, lesions displayed different enhancement. Small vessels arranged in clumps or in line around the tumor during the arterial stage and the enhanced extent of venous stage was more obvious than that of arterial stage. Sign of gastric wall thickening close to lesions was abscent. The accurate rate of localization was 76.5%(13/17) compared with operation. Conclusion: Extra-luminal growth, duplex-growth and absence of gastric wall thickening are characteristic findings of GST in MSCT. The enhanced extent of venous stage superior to that of arterial stage is another feature. Reconstruction of MSCT defines the site, inner ingredients and adjacent tissues of lesion is beneficial to surgery.