胃肠道间质瘤的CT表现

The Application of CT in the Diagnosis of Gastrointestinal Stromal Tumors

目的分析胃肠道间质瘤(GIST)的临床和影像特点,探讨CT检查对该病的诊断价值。方法回顾性分析经手术病理证实的20例GIST的临床和影像资料。结果病变分布于胃11例,十二指肠1例,空肠1例,结肠1例,直肠2例,食管1例,胃肠道外3例。病理分型:良性0例,潜在恶性9例,恶性11例。临床表现:腹痛占40%(8/20),腹部肿块25%(5/20),腹胀20%(4/20),排便异常5%(1/20),血便20%(4/20),皮肤黏膜黄染5%(1/20),进食梗噎感5%(1/20)。主要影像学表现为不规则形肿块,其内易出现坏死、液化,增强扫描有中等以上强化。肿块边界清楚或不清楚。有3例出现淋巴结转移,2例出现肝转移,1例出现腹腔转移。结论 GIST的CT表现有一定特征性,CT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 CT imaging features of gastrointestinal stromal tumors（GIST）,and explore the value of CT in diagnosing the disease.Methods The clinical and imaging data of the 20 patients with GIST were analyzed.Results Tumors located in stomach of 11 cases,in duodenum of 1 case,in jejunum of 1 case,in colon of 1 case,in rectum of 2 cases,in esophagus of 1 case and in extra gastrointestinal sites of 3 cases.Immunohistochemical study diagnosed the GIST as benign in 0 case,intermediate in 9 cases and malignant in 11 cases.The common symptoms were abdominal pain（40%）,abdominal discomfort（20%）,abdominal tumors（20%）,gastrointestinal tract bleeding（25%）,abnormal bowel movements（5%）.The main imaging appearances included necrosis and liquefaction of tumors.On enhanced CT scan,the tumor enhanced moderately.Mass border was clear or unclear.Metastases to local lymph nodes occurred in 3 cases,metastases to liver occurred in 2 cases,and seeding in abdominal occurred in 1 case.Conclusion The CT imaging features of GIST have some characteristics.CT examination has high value in detecting its location,and in evaluating its characteristics and treatment.