胃肠道间质瘤31例CT分析

AN ANALYSIS OF CT MANIFESTATION IN 31 CASES WITH GASTROINTESTINAL STROMAL TUMORS

目的分析胃肠道间质瘤(GIST)的CT表现特点,探讨CT对该类肿瘤的诊断价值。方法回顾性分析31例经手术或胃镜病理证实为GIST患者的CT资料。行CT平扫者3例,CT平扫和增强扫描者28例。结果肿块多数向腔外生长(22/31),表现为类圆形或分叶状肿瘤;发生于食管1例、胃21例、十二指肠2例、空肠4例、回肠2例及肠系膜1例。31例GIST中,良性8例,肿块直径多<5cm,密度均匀,边界清楚,均匀强化;恶性23例,肿块直径≥5cm,密度多不均匀,边界可清楚或不清楚,强化明显且不甚均匀;23例肿块内均有坏死,7例出现转移。31例均手术后或胃镜钳取组织光镜观察及免疫组化检查,31例CD117均为阳性,27例CD34阳性。结论CT检查对于GIST的诊断具有很大的价值,但CT表现仍欠缺特异性,确诊仍有赖于病理学检查。

Objective To analyze CT features of gastrointestinal stromal tumors（GIST） and evaluate CT in the diagnosis of the disease, Methods 28 cases were scanned with contrast enhanced scanning ,and 3 cases with no- contrast enhanced scanning in 31 cases with pathologically- proved GIST. Results Predominant extraluminal growth of tumors was a large proportion in our cases, which appeared mainly as oval or multilobular in shape. The tumors originated from esophagus （n= 1）, stomach （n = 21）, duodenum （n= 2）, jejunum （n = 4） or ileum （n = 2）, mesenterium （n = 1）. Of 31 patients with GIST. 8 cases were benign and 23 cases were malignant. The benign lesions were usually below 5 cm in size with well - defined margin and displayed homogeneous density and enhancement, while the malignant lesions were over 5 cm in size and were well - defined or ill - defined, combined with necrosis within all the malignant tumor and displayed heterogeneous density and enhancement. Metastases were seen in 7 of 23 malignant GIST, 31 cases were examined by light microscopy and immunohistochemistry after operation, all 31 cases were positive for CD117. 27 for CD34, Conclusion CT is helpful in diagnosing GIST. therefore, the features are not differential. A confirmed diagnosis relies on the pathological examination.