MSCT及多平面重建技术对胃肠道间质瘤的诊断价值

The diagnostic value of multi-slice CT (MSCT) and its multiplanar reconstruction techniques in the diagnosis of gastrointestinal stromal tumors

目的 分析胃肠道间质瘤的MSCT表现特征,评价MSCT及多平面重建技术对胃肠道间质瘤的诊断价值.方法 回顾性分析经手术病理及免疫组化证实的胃肠道间质瘤31例,31例术前均行MSCT平扫加增强扫描,通过MSCT多平面重建观察肿瘤的MSCT表现特征,并与术后病理对照.结果 肿瘤位于胃20例,小肠8例,食管1例,胃肠道外2例;良性11例,恶性20例;腔外型19例,腔内型6例,腔内外型6例;肿块直径<5 cm 12例,直径>5 cm 19例;15例为实性肿块,有囊变坏死16例,肿块密度大多数不均匀,增强呈中度以上不均匀强化.结论 MSCT及多平面重建技术能清楚显示胃肠道间质瘤的特征,定位准确,但对判断肿瘤良恶性有一定限度.

Objective To evaluate the diagnostic value of MSCT and its multiplanar reconstruction techniques(MPR) in the diagnosis of gastrointestinal stromal tumors(GISTs) through discussing the MSCT features. Methods Thirty-one cases with gastrointestinal stromal tumors were analyzed retrospectively, which were confirmed by pathology and immuno-histochemistry follow-up.Plain and enhanced MSCT scanning were performed in all cases. CT manifestation in MPR were observed comprehensively and compared with pathological results. Results Tumor located in stomach (n=20), small intestine (n=8), esophagus (n=1), extra-gastrointestine (n=2); 11 were benign, 20 were malignant, there are 19 of extercavitary, 6 of intracavitary, 6 of intra-extercavitary; the diameter of tumor 12 cases were <5 cm in diameter,the diameter of tumor were >5 cm in 19 cases; 15 cases were solid mass, 16 cases were seen necrosis and cystic changes, most of mass had heterogeneous density, on contrast enhanced scans, inhomogeneous moderate or marked tumor enhancement were seen. Conclusions MSCT and MPR can show the characteristics of GISTs clearly and localize GISTs precisely, but it has a certain limit in differentiating benign from malignant GISTs.