胃肠道间质瘤的CT征象与临床病理变化的对比研究

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

目的探讨胃肠道间质瘤(GIST)的影像学特征,观察其CT征象与病理结果的诊断价值。方法选取胃肠道间质瘤患者42例,经病理形态学确诊并分为良性组、交界性组及恶性组,手术切除前经CT平扫及增强诊断其恶性程度,比较肿物大小、密度、形态、强化程度及强化方式等CT征象与肿瘤恶性程度的相关性。结果 CT显示不同恶性程度组别间质瘤肿物大小比较差异有统计学意义(P=0.024),肿物密度均匀性和边缘光滑度比较差异亦具有统计学意义(P=0.041,0.034),而肿物形态在良恶性间质瘤中差异无统计学意义(P=0.631);良性、交界性和恶性间质瘤中CT强化程度比较差异无统计学意义(P=0.628),而强化方式比较各组间差异有统计学意义(P=0.022)。结论 CT显示GIST肿物大小、边缘、密度、强化方式与肿瘤恶性程度相关,CT可作为诊断GIST及其良恶性的重要手段。

Objective To study the CT features of gastrointestinal stromal tumors and evaluate the diagnostic value of CT in the judgement of benign and malignant gastrointestinal stromal tumors. Methods 42 patients with GIST in our hospital were selected for this study. All patients had received CT plain scanning and enhanced imaging, and the tumors were confirmed by pathologists. Patients were then divided into the benign group, borderline group and malignant group. The degree of malignancy was compared with the CT features such as size, density, shape, degree of enhancement and schedule of reinforcement. Results The differences of lesion size in different groups were statistically significant （P=0.024）. The differences in the tumor margin and the density uniformity in the three groups were statistically significant （P=0.041 and 0.034）. There was no significant difference in the degree of enhancement and shape among the three groups （P =0.631 and 0.628）. Conclusion The CT features of tumor size, density uniformity, tumor margin and schedule of reinforcement were closely related with level of malignancy. CT can be used as an important method in the diagnosis of benign or malignant GIST.