胃肠道间质瘤螺旋CT诊断价值

The diagnostic value of spiral CT for gastrointestinal stromal tumors

目的分析胃肠道间质瘤(GIST)螺旋CT影像表现,提高对该病诊断的准确性。方法回顾性分析本院2008年1月～2012年5月收治并行手术治疗及病理证实的20例GIST患者的临床、影像及病理资料。结果肿瘤发生于胃10例,小肠5例,结肠2例,直肠3例。腔内生长者5例,腔外生长者12例,腔内-外混合生长者3例。肿瘤多呈圆形或类圆形,也可呈不规则分叶形。大多数肿瘤密度不均,内部常发生囊变、坏死。增强扫描动脉期多呈轻到中度不均匀强化,门脉期强化较动脉期更明显,而出血、坏死、囊变区无明显强化。结论胃肠道间质瘤CT表现有一定特征性,这些特征不但对GIST定位、定性诊断有重要价值,而且有助于预测肿瘤良、恶性,对预后判断有较好作用。

Objective To improve the accuracy of the diagnosis of gastrointestinal stromal tumors （GIST） by analyzing the performance of its spiral CT imaging. Methods The clinical, radiological and pathological data of 20 cases of GIST patients by operation and pathology from January 2008 to May 2012 were analyzed retrospectively. Results The tumors of 10 cases originated in stomach, 5 cases in small intestine, 2 cases in colon, 3 cases in rectum. The lesions included endo-luminal growth in 5 cases, extra-luminal growth in 12 cases and duplex-growth in 3 cases. The tumors most were round or oval, some irregular lobulated. Most tumors were heterogeneous density, cystic degeneration and necrosis often developed inside. After contrast injection, arterial phase most showed mild or moderate enhancement, portal ve- nous phase more obvious, while the area of hemorrhage, necrosis, and cystic areas had no enhancement. Conclusion Gastrointestinal stromal tumors has characteristic imaging appearance on spiral CT. Spiral CT is not only a useful tech- nology in the diagnosis of GIST, but can help to predict tumor benign or malignant, it has a good effect on prognosis.