CT对胃肠间质瘤的诊断价值

Value of CT in the Diagnosis of Gastrointestinal Stromal Tumor

目的:探讨CT对胃肠间质瘤(GISTs)的诊断价值。方法:回顾性分析经手术病理证实的35例GISTs的CT表现和病理学特点,所有病例均行CT平扫和增强扫描。结果:CT能够准确显示所有肿块的部位、大小、形态,并能判断肿瘤对周围组织结构有无侵犯、有无远处转移。肿瘤发生于胃15例,十二指肠1例,空回肠10例,结直肠6例,肠系膜、网膜及腹膜后各1例。肿块多呈圆形或类圆形。35例GISTs中,低度恶性6例,肿块直径多<5 cm,边界清楚,密度均匀,增强后多均匀强化;高度恶性29例,肿块直径多>5 cm,边界多不清楚,20例肿块内有坏死、液化,密度不均匀,增强后不均匀强化,4例出现转移灶。结论:CT检查对于GISTs定位准确,为肿瘤恶性程度的判断提供依据,为GISTs的治疗方案及手术后或化疗后患者的随访提供重要的信息。

Objective： To discuss the value of CT in the diagnosis of gastrointestinal stromal tumor （GISTs）. Methods：The CT features and pathology characteristics of thirty-five patients with surgery and pathology proved GISTs were retrospectively analyzed. All patients had both plain and contrast enhanced CT scans. Results： The location, size and shape of GIST could be accurately displayed on CT in all cases,as well as whether tumors invaded the surrounding structures and had distant metastases. The tumors originated from stomach （n= 15 ）, duodenum （n= 1 ）, jejunoileum （n=10）, colorectum （n=6）,and mesentery,omentum,retroperitoneum for 1 cases each. The masses were mainly round or oval in shape （n=25）. Of the 35 GISTs,6 tumors showed low degree malignancy and 29 were high degree malignancy. The former were usually 〈 5cm in diameter with well- defined margin and homogeneous in density, homogeneous enhancement was showed after contrast administration. As for the high degree malignant lesions,they were ill-defined and 〉5cm in diameter, with necrotic and liquefied areas within the tumor （n= 20）. Heterogeneous enhancement could be assessed after contrast, distal metastases were showed in 4 cases. Conclusion：CT can precisely display the accurate localization of GIST and provide the information for judging the degree of malignancy, treatment planning and follow-up of patients after treated with surgery or chemotherapy.