胃肠道间质瘤的临床与CT表现

The Clinical Manifestation and CT Findings of Gastrointestinal Stromal Tumors

目的提高对胃肠道间质瘤(GIST)的临床认识和CT诊断水平。方法回顾性分析经病理证实的23例GIST的临床及CT资料。结果临床表现为消化道出血13例,腹痛4例,腹涨2例,无症状4例。病灶分布于胃13例,小肠7例,结肠1例,肠系膜2例;肿瘤平均直径10.3±3.8 cm。病理分型:恶性者21例,良性者2例。CT主要表现为胃肠道粘膜下富血供肿块,外生性生长为主,边界清晰,肿瘤内部出血、坏死,局部淋巴结转移少见。结论GIST临床表现以消化道出血、腹痛、腹胀等为主。CT表现具有典型的特征,CT可作为该病术前诊断及判断预后的主要工具。

Objective To improve our clinical knowledge and the ability of CT imaging diagnosis of gastrointestinal stromal tumors （GIST）. Methods The clinical and CT imaging data of 23 patients with GIST confirmed by pathology were analyzed and summarized. Results The common symptoms were gastrointestinal tract bleeding in 13 cases, abdominal pain in 4 cases, abdominal distention in 2 cases and less symptoms in 4 cases. Tumors were located in the stomach in 13 eases,small bowel in 7 cases , colon in 1 cases and mesentery in 2 cases. The average size of GIST was 10.3 ± 3.8 cm in diameter. Immunohistochemical study diagnosed as benign tumors in 2 cases and malignant in 21eases. The main CT imaging appearances included submucosa of gastrointestinal tract hypervascular tumor, defined margins,predominating exophytic growth,hemorrhage or necrosis within the masses and less metastases to local lymph nodes. Conclusion Main clinical manifestations of GIST were gastrointestinal tract bleeding,abdominal pain and abdominal distention. CT imaging findings were representative. CT is the main tool for preoperational diagnosis, and it can judge the results.