胃肠道间质瘤的影像学表现与良恶性临床病理分析

Image features and clinical pathological analysis of benign or malignant gastrointestinal stromal tumor

目的:总结胃肠道间质瘤的CT和MRI综合影像学表现,结合临床手术病理学资料,提高术前对胃肠道间质瘤良恶性的诊断水平。方法:回顾性分析26例经手术后免疫组化确诊为胃肠道间质瘤患者的CT,MRI影像特征和病理资料。结果:良性肿瘤6例,恶性肿瘤13例,潜在恶性胃肠道间质瘤7例。肿瘤位于胃18例,小肠5例,结肠2例,肠系膜1例;所有患者均无淋巴结肿大。免疫组化显示:CD34阳性率92.3%,CD117阳性率96.2%。结论:检测CD34,CD117是确诊胃肠道间质瘤的金标准;肿瘤大小和核分裂的多少是病理判断良恶性的重要指标;CT,MRI综合影像对胃肠道间质瘤的诊断、鉴别诊断及良恶性趋势判断有重要价值。

Objective To improve diagnostic level before operation by summarizing the CT or MRI comprehensive image features of gastrointestinal stromal tumor and combining the data of surgical pathology.Methods The CT and MRI image features and pathological data of 26 patients with gastrointestinal stromal tumor proved by immunohistochemistry after operation,were retrospectively analyzed.Results Among the 26 cases of gastrointestinal stromal tumor,6 cases were benign tumors,13 cases were malignant tumors and 7 were gastrointestinal stromal tumor.And 18 were located in stomach,5 in small intestine,2 in colon and 1 in mesentery.No lymphadenectasis was found.The pathology and immunohistochemistry showed positive rates of CD34 and CD117 was 92.3% and 96.2%.According to clinical features and the microscope demonstrations,the features of CT and MRI were compared and analyzed in 26 cases.Conclusion The determination of CD34 and CD117 is the golden criterion in diagnosis of gastrointestinal stromal tumor.The size of tumors and the amount of karyokinesis plays an important role in judging benign or malignant tumors.Comprehensive image of CT and MRI is of great value in diagnosing and identifying gastrointestinal stromal tumor.