间质瘤的CT表现和临床病理对照分析

目的提高对间质瘤的影像学认识水平。方法对照分析21例腹部间质瘤的临床、CT及病理资料,并进行总结。结果胃肠道间质瘤15例表现为腔内或腔外生长的肿块,常伴表面溃疡,密度多不均匀,对应于病理的变性、出血和坏死。4例肠外间质瘤表现与之相仿,但体积更大,未见溃疡。肝转移6例、腹腔转移3例,手术与CT表现一致。2例复发性肿瘤都位于原部位,伴周围种植或转移,密度可降低。病灶定位、周围浸润、肝脏及腹腔转移与手术符合率达94.7%(18/19),良恶性的判断与病理相差较大,不符合率36.8%(7/19)。结论间质瘤有一定的影像学特征,CT作为主要的检查手段,有助于定位定性诊断和评价病程。在无明确转移的情况下,良恶性判断困难。术后患者均应随访。

Objective To improve the imaging level of the gastrointestinal stromal tumors（GIST） and exphytic gastrointestinal stromal tumors （EGIST）. Methods The clinical,imaging and pathological date were collected and anaglyzed. Results 15 cases of GIST showed the endophytie or exphytic tumors with heterogeneous density, corresponding to the degeneration,hemorrhage necrosis and cystic changes.Most of them with suffuse ulcer.4 cases of EGIST showed the same imaging features with GIST, but bigger and no surfuse ulcer.6 cases of liver metastases and 3 cases of abdominal transfer detected at CT were identifed by operational findings.2 cases of relapsed tumors were in the original location,with planting or transfer around,the density can reduced. Imaging was correct for location, transfer, planting in 18 cases of 19,all 2 cases of relapsed tumors.Judgement of benign and malignant in CT was large difference with pathological （7/19）. Conclusions GIST and EGIST have some imaging features.CT is useful in detecting and characterizating lesions,Without clear transfer ,benign and malignant judgement is difficult, all patients should be folowed up.