胃肠道间质瘤的螺旋CT诊断价值

目的：探讨螺旋CT平扫和增强扫描对胃肠道间质瘤（GISTs）的诊断价值。方法：回顾性分析33例经手术、病理及免疫组化证实的GISTs患者螺旋CT表现。结果：平扫33例中，瘤体呈均匀等密度10例，肿块周边呈等密度中间略低或不均匀低密度23例。增强扫描16例中，病灶区呈中度或明显均匀强化9例，不均匀强化并可见囊状改变4例，病灶中央大片状坏死伴周边部明显强化3例。33例中良性9例，肿块直径多小于5cm，且呈圆形、类圆形，规则，边界尚清楚；恶性24例，直径多大于5cm，多数向腔外生长，边界不清楚，5例肿块中有坏死出血，4例发现转移灶。结论：螺旋CT检查对GISTs诊断虽无特异性，但可以准确定位，发现转移灶，显著提高GISTs的检出率，弥补常规胃肠道造影和内窥镜检查的不足，对GISTs术前定位和鉴别诊断均有重要价值。

The Diagnostic Value of Spiral CT in Gastrointestinal Stromal Tumors

Objective:To investigate the value of spiral computer tomography (SCT) in diagnosis of gastrointestinal stromal tumors (GISTs).Methods:The SCT features of 33 patients,who had been finally diagnosed as GISTs by operations,pathological examinations and immunohisto chemistry,were retrospectively analyzed.Results:Among 33 cases underwent plain CT Scanning,the tumors showed homogeneous isodensity in 10 cases,and isodensity in the edge and inhomogeneous or low density in the centre of lumps in 23 patients.In the 16 cases receiving enhanced CT scanning,there were 9 cases with obvious or middle enhancement,4 with inhomogeneous enhancement and capsular shape,and 3 with large necrosis of central area and obvious enhancement around.In all 33 cases,there were 9 cases with benign tumors,which present as round or ellipse with regular boundary,less than 5 cm in diameters.Other 24 malignant cases displayed obscure boundary of tumors with more than 5cm in diameters,among them,5 cases with necrosis and hemorrhage,and 4 with metastasis.Conclusions:In spite of the SCT had no specificity in GISTs diagnosis,it had many other benefits,including locating the foci exactly,finding the metastases,increasing the detection rate of GISTs notably,compensating the deficiency of gastrointestinal radiography and endoscopy.In short,the SCT has significant value in differential diagnosing and locating foci of GISTs before operation.