MSCT对胃间质瘤的诊断价值

目的：探讨胃间质瘤的MSCT征象，提高对该病的诊断及定性诊断水平。方法：搜集本院2009年1月-2013年9月手术病理证实的18例胃间质瘤的临床和影像学资料，分析其MSCT特点，包括肿瘤的生长方式（腔内型、腔外型或腔内外型）、大小（〈或≥5cm）、囊变、坏死、钙化、溃疡、强化程度及方式、区域淋巴结是否肿大和远处器官是否有转移等，判断上述征象对间质瘤良、恶性的鉴别诊断价值。结果：18例胃间质瘤均为单发病灶，其中恶性9例，潜在恶性5例，良性4例。发生坏死、侵犯周围组织、腹腔淋巴结肿大、远处转移的间质瘤几乎全是恶性或潜在恶性，肿瘤≥5cm、腔外或腔内外型生长、囊变、溃疡、钙化、不均匀强化的病变，恶性及潜在恶性几率明显增加。结论：胃间质瘤的MSCT征象具有一定特征，肿瘤出现坏死、侵犯周边组织、区域淋巴结肿大和远处器官转移可判断为恶性及潜在恶性。

Diagnostic value of MSCT in gastric stromai tumors

Objective：To explore the MSCT findings of the gastric stromal tumors （GST） in order to improve differen tial accuracy of imaging features among malignant, potential malignant and benign tumors. Methods：Clinical and imaging da ta of 18 patients proved by surgery and pathology with GST during January 2009 to September 2013 were collected. MSCT features of GST included growth pattern （endoluminal, extraluminal or dumbbel!）,size （less or more than 5cm）, cystic de generation, necrosis, calcification, ulceration, pattern （homogeneous and inhomogeneous） and degree of enhancement, metastases of regional lymph nodes or distant organs, were analysed retrospectively by two senior radilogists. Values of all the MSCT features in differentiate benign and malignant GST were evaluated. Results： 18 patients with GST had a solitary le-sion. 9 of them were malignant, 5 were potential malignant and 4 were benign. Neoplastic necrosis,adjacent invasion, region al lymphadenopathy and distant metastases were all indication of the malignancy or potential maligancy. The possibility of the malignancy and potential malignancy were higher among the tumors with diameter more than 5era, exophytie or dumb bell growth pattern, cystic degeneration, ulceration, calcification and inhomogeneous enhancement. Conlusion：CT findings of the GST had certain characteristics. GST with neoplastic necrosis, adjacent tissue invasion, regional lymphadenopathy and distant metastases may help to identify the predictor of the tumor＇s malignancy and the potential malignancy.