胃肠道间质瘤29例的钡剂造影及CT扫描影像分析

目的探讨胃肠道间质瘤(GIST)的胃肠钡剂造影征象和CT的影像表现。方法参照手术病理结果,对29例经病理证实分别为良性、交界性及恶性GIST的钡剂造影及CT扫描的影像表现进行回顾性分析,总结不同性质GIST的钡剂造影及CT扫描影像特点。结果GIST良性体积小,钡剂造影主要表现腔内小充盈缺损,蠕动波变小,CT平描时密度多较为均匀,且呈均匀强化;交界性肿瘤体积较大,钡剂造影显示小溃疡,可见腔内较大充盈缺损,蠕动波消失,CT平描一般密度不均匀且不均强化;恶性肿瘤体积大,钡剂造影时一部分表现为龛影及较大充盈缺损,局部腔壁僵硬;另一部分仅表现为胃肠道受压。CT平扫显示跨壁或壁外巨大肿块,一般密度不均;增强扫描以不均匀强化为主。恶性肿瘤可发生肝脏、胰腺及周围腹膜等组织转移,但未见淋巴结转移。结论GIST的钡剂造影缺乏特征性,但该检查对于发现病变、定位病变及初步定性还是有利的,CT影像有一定特征性,该检查对GIST的定位和准确定性有较大临床价值。

Objective To analyze the clinical imaging features of the Gastrointestinal Stromal Tumors（GIST） by CT scan and Barium meal.Methods The imaging features of benign and borderline and malignant tumors of GIST by CT scan and Barium meal which have been confi rmed by pathology of 29 cases which were retrospectively analyzed.Results Among the tumors,benign tumors were small,the principal imaging features of which by barium meal were small fi lling defects,the peristaltic waves had diminished,what＇s more,the density of the tumors in plain CT scan were frequently homogenous and were always uniformly enhanced in double phase enhanced CT.Borderline tumors were bigger,we can see aphthae and comparatively large fi lling defects by Barium meal,peristaltic wave could not pass,the most of the tumors appealed inhomogeneous density in plain CT scan and uniform enhancement in double phase enhanced CT.Malignant tumors were big,one part of it appeared niches and comparatively large fi lling defects and rigidity wall by Barium meal,peristaltic waves couldn＇t pass,another part of it only appealed in compressed stomach intestine.Plain CT scan show big tumors whose main body part straddled stomach intestine or is out of stomach intestine,the tumors appeared inhomogeneous density,enhancement scan show inequable enhancement in most of the cases.Within the malignant tumor cases,metastatic tumors were discovered at the organization of liver and pancreas and tumors could invade surrounding tissues.Nevertheless,lymphadenectasis hadn＇t discovered.Conclusion Although the imaging of GIST by Barium meal lack of characteristics,The Barium meal were advantage to discover and locate and initially determine the nature diseases.The imaging of GIST by CT scan has some special characteristics,which can help to locate and determine the nature of the tumors accurately.