肠道来源胃肠道间质瘤的CT诊断

CT diagnosis of intestinal stromal tumors

目的：分析肠道来源胃肠道间质瘤的CT表现特征，探讨CT对其诊断价值。资料和方法：回顾性分析经手术和病理证实的15例肠道间质瘤的CT征象，并将大体病理所见与CT表现相对照。结果：15例中起源于十二指肠5例，空肠4例，回肠3例，结肠2例，累及多节段肠管1例。CT表现为腹腔或盆腔的软组织肿块，肿块最大径约2.7-24cm，〈5cm 5例，其中2例为良性，≥5cm 10例，均为恶性；边界不规整7例；平扫密度不均匀12例，增强后多呈轻中度不均匀强化；肝转移2例，复发2例；术前误诊4例，精确定位6例，粗略定位5例。结论：虽然术前肠道间质瘤的精确定位比较困难，但是通过CT检查可以有效观察肿瘤自身及其与周围组织结构的关系，协助临床与病理，是最终确定肿瘤良恶性的重要参考。

Objective： To investigate the CT features of intestinal stromal tumors and its diagnostic value. Materials and Methods： The CT imaging data of 15 cases with intestinal stromal tumors confirmed by operation and pathology were analyzed retrospectively, the gross pathologic findings of the tumors were compared with the manifestations of CT. Results： Among the 15 cases, 5 cases located at duodenum, 4 cases at jejunum, 3 cases at ileum, 2 cases at colon, 1 case at multisegments of intestine and colon. All cases presented as celiac or pelvic soft tissue tumors with diameter of 2.7-24cm, 5 cases were less than 5cm and 2 cases of them were benign, 10 cases were larger than 5cm which were all malignant; Seven cases presented with a irregular margin; Twelve cases showed heterogeneous density on plain scan with slightly and moderately heterogeneous enhancement; Two cases had liver metastasis, 2 cases recurred; Four cases were preoperatively misdiagnosed, 6 cases were localized precisely and 5 roughly. Conclusion： Although precisely preoperative localization of intestinal stromal tumors is difficult, CT findings of tumor features and the relationship with adjacent tissues or organs can be of great help and also for evaluation of malignant or benign lesions.