胃肠间质瘤的MSCT和MRI表现及病理对照研究

目的:探讨胃肠间质瘤(GISTs)的MSCT和MRI表现特征及与大体病理的关系。方法:分析经手术病理证实的23例GISTs患者的影像学资料,23例均行CT平扫、动态三期扫描,其中8例行多平面重组(MPR)技术;9例行MRI平扫,并将大体病理标本与CT和MRI表现进行对照。结果:23例中22例单发,1例多发(肠系膜2个病灶)。其中食管1例,胃14例,十二指肠2例,空肠2例,回肠1例,肠系膜2例,大网膜1例。位于胃肠道的间质瘤以向腔外生长居多。体积较小者密度/信号均匀;体积较大者密度/信号不均匀,可见坏死、囊变或出血区,增强检查肿瘤实质部分呈中度或明显均匀强化。MSCT和MRI检出所有肿瘤肉眼可见的坏死、囊变或出血区,且反映的范围与大体病理基本一致。结论:MSCT的MPR和MRI的多方位成像技术有助于GISTs的定位并可清楚显示肿瘤与周围组织结构的关系;MSCT和MRI表现能够反映胃肠间质瘤的大体病理特征。

The Imaging Features of Multi-Spiral CT and MRI in Gastrointestinal Stromal Tumors and Correlation with Pathology

Objective: To investigate the imaging features of MSCT and MRI in gastrointestinal stromal tumors (GISTs) and their pathological manifestations. Methods: All imaging data of 23 cases with surgically and pathologically proved GISTs were retrospectively analyzed. Plain and dynamic three-phase enhanced CT scans were done in all cases,and the techniques of multiple planar reconstruction were performed in 9 cases. Plain MRI scans were performed in 9 cases. All images were compared with gross pathology. Results: Twenty-two of all originated single, 1 originated multiple(two lesions in mesentery), 1 in esophagus, 14 were located in stomach, 2 in duodenum, 2 in jejunum, 1 in ileum, 2 in mesentery and 1 in omentum. They most commonly had an exophytic growth pattern. The tumors of smaller volume had homogeneous density on CT /signal inten-sity on MRI, whereas those of larger volume had inhomogeneous density on CT /signal intensity on MRI. Solid parts of all tu-mors showed moderately or obviously enhanced after contrast-material administration. All of cystic necrosis or hemorrhage ar-eas of the tumors seen by naked eyes were detected by MSCT and MRI, and the scopes of those areas were consistent with gross pathology. Conclusion: MSCT and MRI findings of GISTs were specific to a certainty. The techniques of multiple plan-nar reconstruction of MSCT and multipleplanar imaging of MRI have important value of the locations of the tumors and detect-ing the relationship between the tumors and surrounding tissues and organs.