胃肠道间质瘤的多层螺旋CT诊断

Diagnostic of MSCT in gastrointestinal stromal tumor.

目的探讨多层螺旋CT(MSCT)对胃肠道间质瘤(GISTs)的诊断价值。方法对45例经手术病理证实的胃肠间质瘤的CT表现和临床特征作回顾性分析,所有病例均行CT平扫和增强扫描。结果 45例中发生在胃19例,十二指肠2例,空回肠14例,结肠6例,肠系膜2例,网膜及腹膜后各1例。肿块多呈圆形或类圆形,良性11例(胃5例、空回肠3例、结肠2例、十二指肠1例),交界性8例(胃4例、空回肠4例),恶性26例(发生在胃10例、空回肠7例、结肠4例),良性者直径多<5cm,边界清楚,密度均匀,恶性者直径多>5cm,边界不清,密度不均匀。本组23例肿块内有坏死、液化及囊变,实性部分位于肿块周围,囊变、坏死区多位于中央。增强后实性部分动脉期轻度强化,静脉期中度强化,实质期仍保持强化,坏死、囊变区无强化,6例出现转移灶。结论 MSCT检查可明确GISTs的发生部位,肿瘤形态、大小和内部结构。GISTs的MSCT表现有一定的特征性,对初步鉴别肿瘤的良恶性有重要临床价值。

Objective To discuss the value of MSCT in the diagnosis of gastrointesinal stromal tumor（GISTs）.Methods The MSCT features and clinic characteristics of forty-five patients with surgery and pathology proved GISTs were retrospectively analyzed.All patients had both plain and contrast enhanced CT scans.Results Among total 45 cases of GISTs.The tumors originated from stomach（n=19）,cluodenum（n=2）,jejunoileum（n=12）,colorectum（n=8）,mesentery（n=2）,and omenttan,retroperitoneum for 1 cases each.The masses were mainly round or oval in shape.11 cases were begin（5 lesions in stomach,3 lesions in jejunoileum,2 lesions in colorectum and 1 lesions in cluodenum）.8 cases were potential malignant（stomach and jejunoileum for 4 cases each）.26 cases were malignant（10 lesions in stoma ch 7 lesions in jejunoileum and 4 lesions in colorecttum）.The tumor diameters were always less than 5cm,with well-defined margin and homogeneous in density,the potential malignant and high degree malignant lesions,they were ill-defined and 5cm in diameter with necrotic and liquefied areas within in tumor（n=23）.The enhancement degree on venous phase was ligher than that on arterial phase.There was no enhan-cement of cystic degeneration and necrosis in tumors.9 cases developed recurrence and 6cases metastasis.Conclusion MSCT scans have great clinic value in providing information regarding location,shape,size,internal structure.Intra-abdominal GISTs have some MSCT fectures and preliminary identifing of benign and malignant tumors.