外生型胃肠道间质瘤影像学表现及误诊分析

CT and barium meal fingdings of exogenic stromal tumor and misdiagnosis analysis

目的研究外生型胃肠道间质瘤的CT、钡餐造影特征及误诊原因,以提高外生型胃肠间质瘤的诊断水平。方法回顾性分析经手术病理证实的10例外生型胃肠道间质瘤影像表现;检查方法包括:口服阳性对比剂CT平扫加增强扫描加三维重建(10例);全消化道钡餐造影检查(5例)。结果 10例研究对象中,CT定位正确8例(80%),其中定位胃2例,小肠6例,误诊2例。定性诊断正确6例(60%)。消化道钡餐定位5例,正确率100%。定性诊断正确3例(60%)。结论外生型胃肠道间质瘤CT特征:病灶体积大;中心坏死明显;肠间肿物,窦道不容易显示。钡餐造影可显示窦道,确定间质瘤与肠管的关系。对肿块与胃肠道关系的错误判断是外生型间质瘤误诊的主要原因。薄层增强CT扫描结合全消化道钡餐造影,能明显提高外生型胃肠道间质瘤的诊断准确率。

Objective To investigate the findings of CT and barium meal of exogenic stromal tumor, and analyze the causes of misdiagnosis. Methods Image data of 10 patients with exogenic stromal tumor his- tologically confirmed were retrospectively analyzed. Inspection methods included CT scan plus three-dimen- sional reconstruction and barium meal. Results Among 10 patients examined by CT scan, 8 cases can be cor- rectly orientated. The tumor was located in stomach in 2 cases, in intestine in 6 cases. The remaining 2 cases were misdiagnosed. Etiologic diagnosis of 8 cases was correct. Five patients examined by barium meal all cor- rectly orientated （5/5）, but etiologic diagnosis was correct only in 3 cases （3/5）. Conlusion Diagnostic power of CT scan and G1 barium meal was strong, but the etiologic diagnosis of CT scan was more reliable than GI barium meal.