胃肠间质瘤的临床与影像分析(附20例报告)

Clinical and imaging analysis of gastrointestinal stromal tumors(report of 20 cases)

目的:分析胃肠道间质瘤(GIST)的临床和影像特点,探讨影像学检查对该病的诊断价值。方法:回顾分析经手术病理证实的20例GIST的临床和影像资料。结果:病灶分布于胃3例,十二指肠1例,小肠11例,结肠1例,胃肠外4例。病理分型:良性1例,潜在恶性7例,恶性12例。临床表现为消化道出血占25%(5/20),腹部触及肿块30%(6/20),腹痛65%(13/20),排便异常15%(3/20)。主要影像学表现是外生性为主的肿块,肿块易出现坏死、液化,增强扫描有中等以上强化。肿块边界可以清楚或不清楚,很少出现淋巴结转移,易发生肝内转移或腹腔种植。结论:GIST的影像学表现有一定特征性,CT、MRI检查对其定位、良恶性的判断、随诊治疗有较高的价值。

Objective： To analyze the clinical and imaging features of gastrointestinal stromal tumors（GIST） and explore the imaging value in diagnosing the disease. Materials and Methods： The clinical and imaging data of 20 patients with GIST proved by operation and pathology were analyzed. Results： Tumors located in stomach 3 cases, in small bowel 11 cases, in colorectum 1 case and in extra gastrointestinal sites 4 cases. Immunohistochemical study diagnosed the GISTs as benign in 1 case, intermediate in 7 cases and malignant in 12 cases. The common symptoms were gastrointestinal tract bleeding（5/20）, vague abdominal discomfort and abdominal pain （13/20）, abdominal tumors （6/20） and abnormal bowel movements （3/20）. The main imaging appearances included predominating exophytic growth, necrosis and liquefaction of tumors. On enhanced CT scan, the tumor enhaneed moderately. Mass border is clear or unclear and metastases to local lymph nodes is uncommon, but it is easy to metastase to liver or seeding in abdominal cavity. Conclusion： The imaging features of GIST have some characteristics. CT, MRI examination have high value in detecting its location, evaluating its characteristics and treatment.