螺旋CT对胃肠道间质瘤的诊断价值

目的探讨胃肠道间质瘤（G ISTs）的螺旋CT征象与诊断价值。方法收集经手术病理证实的27例胃肠道间质瘤,回顾性分析其在CT扫描中的特征。术前均行平扫、增强双期扫描。结果肿瘤均为单发,位于胃14例,小肠5例,十二指肠3例,直肠2例,食管、肠系膜、腹膜后各1例。肿块多呈类圆形或浅分叶状,良性5例,直径在3~5 cm,增强强化均匀;交界性5例,直径在4~7 cm,呈均匀或不均匀强化;恶性17例,肿块直径均〉5 cm,增强明显不均匀强化,其内见不规则坏死、囊变区域。螺旋CT对该组病灶的定位准确度为93%,定性为78%。结论螺旋CT对胃肠道间质瘤的定位、良恶性判定具有较高的应用价值,对临床治疗方案及预后评估起到重要的作用。

Value of spiral CT in the diagnosis of gastrointestinal stromal tumor

Objective To investigate the CT feature and the diagnostic value of spiral CT in gastrointestinal stromal tumors（GISTs）.Methods 27 patients of GISTs were proved by surgery and pathology confirmed,retrospective analysis of the characteristics of the CT scan.Before the operation,all patients had both plain and dual-phase enhanced CT scans.Results Tumors are all singles.The tumors originated from stomach（n=14）,5 in the small intestinum,3 in the duodenum,2 in the rectum,and esophagus,mesentery,retroperitoneal hernia for 1 cases each.The masses were mainly round or oval or Light a leaf shape,with benign GIST（5 cases）,diameter between3-5cm,demonstrated homogeneous enhancement.Potentially malignant（5 cases）,diameter between 4-7cm,demonstrated homogeneous enhancement or heterogeneous enhancement.Malignant（17 cases）,diameter all5cm,demonstrated obviously heterogeneous enhancement.It can be seen anomaly necrosis,cystic change.The positive prediction and accuracy rate with spiral CT for the localization of GIST was 93% in this group of tumor,qualitative diagnosis was 78%.Conclusion Spiral CT was capable of precisely localizing the sites and the differental diagnosis between benign and malignant GIST,for the clinical treatment planning and after evaluation play an important role.