胃肠间质瘤的多层CT诊断

MSCT Diagnosis of Gastrointestinal Stromal Tumor

目的:探讨多层CT(MSCT)在胃肠间质瘤(GIST)诊断中的价值。方法:回顾性分析经手术和病理证实的56例GIST的MSCT表现,所有病例均行平扫、增强扫描及多平面重组。结果:病灶准确定位于胃28例、小肠6例、结肠8例和肠系膜6例,其余8例未能准确定位,定位准确率为85.7%(48/56)。肿瘤最大径2.0～21.0cm,平均(7.3±4.6)cm。肿瘤呈球形32例、分叶状22例及小结节形2例。边界清晰40例,与周围组织分界不清16例。49例外生性生长,7例腔内生长。3例肿瘤内部坏死,并与肠管沟通。肝脏转移8例,淋巴结转移7例,肠系膜转移3例。5例发现肠梗阻征象。43例(直径>5cm)平扫密度不均,增强后不均匀强化;13例(直径≤5cm)平扫密度均匀,增强后均匀强化。高度恶性定性准确率91.1%(41/45)。结论:GIST具有典型的MSCT表现。MSCT定位准确率高,高度恶性定性准确,可为临床诊治GIST提供详细的依据。

Purpose：To investigate the value of multi-slice spiral computed tomography （MSCT） in diagnosing gastrointestinal stromal tumors（GIST）.Methods：The CT imaging findings of 56 patients with GIST confirmed by surgery and pathology were analyzed and summarized. All the cases were performed with plain and enhanced scan and multiplanar reconstruction.Results：The lesions were located in the stomach （n=28）,small bowel （n=6）,colon（n=8） and mesentery（n=6）.And 8 lesions can＇t be located. The diameters of the mass were ranged 2.0～21.0cm. The average size of GIST was 7.3 ± 4.6cm.The appearances of the tumors included globular shapes （n=32）,sublobe shapes（n=22）,lesser tubercle shapes （n=2）,sharpness of border （n=40） and obscure boundary （=16）.The growth types of the tumors included exophytic growth （n=49）,intracavitary growth （n=7）,necrosis and invaded intestinal canal（n=3）,liver metastasis （n=8）,celiac lymph nodes metastasis （n=7）,mesentery metastasis （n=3）and bowel obstruction （n=5）. The CT appearance of heterodensity on plain scan and heterogeneous enhancement was found in 43 cases （D5cm）. The CT appearance of uniformity density on plain scan and uniformity enhancement was found in 13 cases （D≤5 cm）. The accuracy rate of CT diagnosis for advanced malignant pathologic features of GIST was 91.1%（41/45）.Conclusion：MSCT imaging appearance of GIST was considered representative.The locating and qualitation diagnosis of GIST by MSCT are accurate.