胃肠道间质瘤的影像表现与病理对照研究

Gastrointestinal stromal tumors:imaging features with intraoperative and clinicopathological correlation

目的提高对胃肠道间质瘤(GIST)的影像认识水平。方法回顾性分析20例 GIST的临床、影像及病理资料。结果影像表现为内生或外生性生长的肿块,密度或信号多不均匀,对应于病理学中的出血、坏死、黏液及囊变。与术中及病理结果对比,影像确定病变起源部位正确11例(11/16),4例 CT 判定肿瘤复发的位置与术中表现一致。术前 CT 均未能提示5例腹腔内多发结节。CT 显示3例肝脏转移瘤得到术中证实。结论 GIST 有一定的影像特点。CT 作为主要的影像评价手段有助于病灶的检出及定性,对肠系膜、腹膜及网膜转移灶的检出仍有不足。

Objective To analyze imaging of gastrointestinal stromal tumors （GIST）, and to compare their imaging features with operational and pathological findings. Methods Clinical, imaging, and pathological data of 20 patients with GIST were collected. Results Imaging findings were endophytic or exophytic tumors with heterogeneous density or signal intensity, corresponding to hemorrhage, necrosis, and cystic changes. Imaging was correct for the location of the lesion in 11 of 16 primary GIST and 4 cases of relapsed tumors. Preoperational CT did not detect mesenteric, peritoneal, and omental metastasis in 5 cases. Hepatic metastases detected at CT （3 cases） were identified by operational findings. Conclusions GIST has some imaging features. CT is a useful tool in detecting and characterizating of lesions rather than detecting mesenteric, peritoneal, and omental metastasis.