胃肠道间质瘤的CT诊断

CT Diagnosis of Gastrointestinal Stromal Tumors

目的探讨CT对胃肠道间质瘤的诊断价值。方法回顾性分析15例胃肠道间质瘤的临床及影像学资料。结果肿瘤平扫呈等密度者3例,肿块周边呈等密度,中间呈略低密度或低密度者12例。增强扫描,病灶中度或明显强化者3例,不均匀强化,其内可见多个小囊状坏死者7例;病灶中央坏死、液化周边强化者5例。15例GISTs中,良性4例,肿块直径多<5cm,边界清楚,多均匀强化;恶性12例,肿块直径>5cm,边界多不清楚,12例肿块内均有坏死,2例出现转移灶。结论 CT检查对于GISTs良恶性的判断很有价值,但CT表现无特异性,确诊仍有赖于病理学检查。

Objective To analyze CT features of gastrointestinal stromal tumors and to evaluate CT in the diagnosis of the disease. Methods The clinical and imaging data of 15 patients with gastrointestinal stromal tumors were analyzed and summarized. Results On plain CT scans,the tumors showed homogeneous isodensity（n=3）,or low density centrally with isedensity peripherally（n=12）.On enhanced CT scans,moderate or marked enhancement was seen in 3 cases.heterogeneous enhancement with small cyctic necrosis in 7,and central necrosis with peripheral enhancement in 5.Of 15 GISTs,4 was benign and 11 were malignant.The benign lesions were usually below 5cm in size with well--defined margin and displayed homogeneous enhancement.The malignant lesions were ill--defined margin and over 5cm in size,with necrosis within the tumor（n=12）or metastases（n=2）.Conclusion CT is very helpful in differentiating benign with malignant GISTs,although it is difficult to differentiate from leiomyoma or-leiomyosarcoma as GISTs shows no characteristic CT signs,therefore,a confirmed diagnosis relies on the pathological examination.