多排螺旋CT对小肠间质瘤的诊断价值

目的应用多排螺旋CT扫描及多平面重建技术（MPR），分析小肠原发性间质瘤的CT表现特征及其应用价值。方法回顾性分析37例经病理及免疫组化证实的小肠间质瘤患者的临床及影像学资料。其中25例有完整的CT影像资料，CT特征包括肿瘤位置、大小、形态、强化特征、转移等。结果37例小肠间质瘤中，十二指肠11例、空肠16例，回肠5例，肿瘤发生位置判定困难5例。其中良性间质瘤8例，恶性间质瘤24例，低度或潜在恶性间质瘤5例。CT包括良性间质瘤5例，恶性和交界恶性20例。CT发现肿瘤坏死18例（72％），侵犯周围结构10例（40％），转移瘤1例（4％）。肿瘤以肠腔外生长为主，平均直径7．9cm。未见肠梗阻及淋巴结转移征象。结论CT在小肠间质瘤的检出及定位方面有重要作用，能准确反应病变的生物学行为，对小肠间质瘤的定性诊断有重要价值。

Diagnostic value of multidetector spiral CT in small intestinal stromal tumors

Objective To describe the CT appearances of small bowel primary gastrointestinal stromal tumor （GIST）. Methods Between January 2005 and December 2007, 37 patients were pathologically and immunohistochemicaUy diagnosed as small bowel GIST. Among them, 25 cases had complete CT data, including multiplanar reconstruction （MPR） images. The clinical data and CT images were retrospectively reviewed. The CT findings were assessed for tumor location, size, shape, enhancement characteristics, and metastasis. Result The primary tumor sites included duodenum （n = 11 ）, jejunum （n = 16）, and ileum （n = 5）. The primary site was not confirmed in 5 patients. Eight cases （21.6%） were pathologically diagnosed as benign, and the vemaining were confirmede as malignant （24/37） or borderline （5/ 37）. CT findings included benign lesion （ n = 5 ） and malignant/borderline （ n = 20）. The CT appearance included central fluid attenuation in 18 tumors （72%）, infiltration in 10 tumors （40%）, and me- tastasis in 1 patient （4%）. The average diameter of the primary tumor was 7.9cm. Neither intestinal obstruction nor lymph nodal enlargement was found. Condusions CT plays an important role in the detection and location of small bowel tumor as well as a critical role in determining the nature of GIST. The CT findings, especially MPR images, are valuable for the qualification of small bowel GIST nature.