胃肠道良恶性间质瘤CT征象及其与临床病理对照研究

The CT features of benign and malignancy gastrointestinal stromal tumors and its comparative study with clinical pathology

目的分析胃肠道良恶性间质瘤的影像学表现,评价CT对胃肠道间质瘤(GIST)良恶性的诊断价值。方法选择经手术病理及免疫组化证实的GIST患者35例CT平扫及增强影像,以临床病理学结果及免疫组化结果将病灶分为良性、交界性及恶性3组,比较3组病灶的生长部位、体积、形态、密度、强化程度、有无转移等影像学表现特点。结果 35例GIST患者均为单发病灶,其中良性肿瘤13例,交界性肿瘤6例,恶性肿瘤16例。良性、交界性及恶性间质瘤病灶体积比较差异有统计学意义(P<0.05),病灶强化程度比较差异无统计学意义(P>0.05),转移率比较差异无统计学意义(P>0.05),而病灶的边缘光滑程度、病灶形态分叶性状及密度均匀性比较差异有统计学意义(P<0.05)。良性间质瘤CT平扫示密度多均匀,边缘多光滑,增强程度11～62Hu,肿瘤最大径线均<5.0cm;交界性、恶性间质瘤CT平扫密度大多不均匀,边缘光滑或不规则,增强扫描均呈不均匀强化,最大直径均>5cm。结论 CT可作为GIST良恶性诊断的重要检查方法。

Objective To evaluate the diagnosis value of CT in judging benign and malignant of gastrointestinal stromal tumors（GIST） by analysing the imaging of it.Methods The 35 cases of patients with GIST confirmed by operation pathology and immunohistochemistry were selected and received CT plain scanning and enhanced imaging.The lesions were divided into benign group,borderline group and malignant group by clinical pathology and immunohistochemistry.Compared the imaging performance characteristics such as lesion growth position,size,shape,density,degree of enhancement,with or without metastasis and clinical manifestation of 3 groups.Results The lesions of 35 patients with GIST were solitary.13 cases were benign;6 cases were borderline tumors;16 cases were malignant.The differences of lesion size in 3 groups were statistically significant（P〈0.05）;there was no significant difference of degree of enhancement and diversion rate between 3 groups（P〈0.05）;The differences of edge smooth degree,lesions form and density uniformity in 3 groups were statistically significant（P〈0.05）.The CT manifestation of benign mesenchymal tumor showed that density more uniform,edge more smooth,the degree of enhancement from 11 to 62HU and maximum tumor diameter was less than 5.0cm.The CT manifestation of borderline and malignant stromal tumor showed that density more non-uniform,edge smooth or irregular,enhanced scan were heterogeneous enhancement and maximum diameter was larger than 5cm.Conclusion CT can be used as a important inspection method for benign or malignant diagnosis of GIST.