胃肠道间质瘤的MSCT诊断

Diagnostic value of multi-slice spiral CT in gastrointestinal stromal tumor

目的:探讨胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的MSCT表现特征。方法:回顾性分析经手术和病理证实的46例GIST的MSCT资料。结果:46例中,GIST位于食管1例,胃部15例,十二指肠12例,空回肠11例,结肠3例,直肠1例,肠系膜内3例;恶性肿瘤28例,交界性3例,良性15例。46例中35例肿块CT表现为外生性肿块,多较大,其中恶性肿块最大径3.5～30.1cm,最大径<5cm者10例,>6cm者18例;肿物密度不均匀,呈囊实性,实性部分中度强化至明显强化,肿块内伴有溃疡形成4例,最大径>4.5cm。瘤内点状钙化灶4例。结论:GIST的MSCT表现具有一定特点,MSCT检查有助于GIST的定位以及观察肿瘤与周围组织结构的关系情况,对肿瘤诊断及良恶性鉴别有重要价值。

Objective： To investigate the specific multi-slice spiral CT findings of gastrointestinal stromal tumors（GIST）. Methods：The CT images of 46 cases of gastrointestinal stromal tumors confirmed operatively and pathologically were reviewed and analyzed. Resuts： One of the tumors were from the esophagus, 15 from the stomach, 12 form the duodenum, 11 from the jejunum and ileum, 3 from the colon, 1 from the rectum, 3 from the mesenterium. 28 of the 46 GISTs were malignant, 3 of them were potentially malignant, 15 of them were benign. CT studies of 35 of the 46 tumors showed as exogenous mass of 3.5 cm- 30.1 cm. 10 of them with less than 5 cm and 18 of them with over 6 cm in the maximum diameter. The tumors were cystic, solid with inhomogenous attenuation. The solid potion of tumors enhanced from moderately to markedly after the contrast media administered. Ulcer was seen in the tumors of 3 cases and the diameter of both of them were over 4.5 cm. Punetate calci- fication was seen in 4 cases. Conclusion： Multi-slice spiral CT findings of GIST are specific to a certainty. Multi-slice spiral CT study is helpful for locating the tumor and observation of the relationship of the tumor and surrounding structures. It is of im- portant value in the diagnosis and differentiating the benign from manlignant tumors.