胃肠道间质瘤的CT诊断与临床病理分析

CT Diagnosis and Clinical Pathological Analysis of Gastrointestinal Stromal Tumors

目的:探讨胃肠道间质瘤(GIST)的CT表现,以提高对GIST的诊断水平。方法:搜集经手术和病理证实的胃肠道间质瘤32例,回顾性分析其CT和病理表现。所有病例均行CT平扫及增强扫描。结果:32例肿瘤均为单发,位于胃部17例,空肠和回肠7例,结肠及直肠3例,食管1例,十二指肠和肠系膜各2例。良性9例,恶性23例。CT表现为粘膜下富血供性肿块,肿瘤倾向于腔外生长,可有囊变、坏死及钙化。双期增强扫描见静脉期较动脉期强化显著。结论:CT是GIST的主要影像学检查方法,CT表现有一定的特征性,对胃肠道间质瘤的定位和定性判断,以及鉴别诊断有重要价值,但定性诊断需依赖免疫组化和电镜检查。

Objective： To improve the ability of CT diagnosis of gastrointestinal stromal tumors （GIST） through analyzing imaging findings of GIST. Methods： Plain and enhanced spiral CT scan ：was performed in 32 patients with GIST which were proved by operation and pathology. Results： All 32 cases originated single, 17 were located in stomach, 7 in jejunum and ileum, 3 in colon and rectum, 1 in esophagus, 2 in and 2 in duodenum and posterior peritoneum. 9 cases were benign and 23 cases were malignant in 32 cases with GIST. The imaging appearance of CT included submucous hypervascular lesions with predominating exophytic growth. There were obvious necrosis, cystic changes or calcification within the mass. The degree of enhanced CT were more marked in venous phase compared with that in arterial phase. Conclusion： CT is useful imaging technique in the diagnosis of GIST. The imaging findings of CT can reveal some characteristic signs of GIST. CT can precisely localized GIST and is helpful in differentiating benign with malignant GIST. The imaging of CT has important value in differential diagnosis, however, the qualitative diagnosis needs depend on immunohistochemical and eleetronmicroscopic examinations.