不同危险度胃肠道间质瘤CT、MRI影像学特征及分析

CT and MRI features and analysis of gastrointestinal stromal tumors in different risk degrees

目的:探讨胃肠道间质瘤(GIST)患者的CT及MRI表现及其影像学诊断价值。方法:回顾性分析经手术病理证实的26例GIST患者CT及MRI扫描的不同表现。结果:胃部14例(高危4例,28.6%),十二指肠及小肠10例(高危3例,30%),肠外2例(高危1例,50%),肿瘤的发生部位、强化程度及MRI信号特点在GIST的风险评估上无特异性。病灶的危险分级与肿瘤大小[平均直径:低危组(3.37±1.27)cm,中危组(7.60±3.71)cm,高危组(11.15±3.88)cm]、瘤内坏死(低危0/10例,中危5/8例,高危7/8例)及表观弥散系数值[低危组(1.78±0.24)×10^(-3)mm^2/s,中危组(1.72±0.23)×10^(-3)mm^2/s,高危组(1.24±0.11)×10^(-3)mm^2/s]存在显著统计学差异(P<0.05)。结论:CT及MRI检查有助于GIST的诊断及良恶性判断,可为指导临床治疗及预后提供重要参考价值。

Objective To investigate the CT and MRI features of gastrointestinal stromal tumors（GIST） and their diagnostic value. Methods CT and MRI scanning features of 26 cases with GIST confirmed by surgery and pathology were retrospectively analyzed. Results Fourteen cases suffered from the tumors originated from stomach, with 4 high-risk cases,accounting for 28.6%; 10 cases suffered from the tumors originated from duodenum and small intestine, with 3 high-risk cases, accounting for 30%; 2 cases suffered from the parenteral tumors, with 1 high-risk case, accounting for 50%. Tumor location, strengthening degree and MRI signal characteristics showed non-specific in assessing the risk of GIST. The average diameters of tumors were respectively（3.37 ± 1.27） cm,（7.60 ± 3.71） cm,（11.15 ± 3.88） cm, and the intra-tumor necrosis conditions were respectively 0/10, 5/8, 7/8, and the apparent diffusion coefficients were respectively（1.78±0.24）×10^（-3）mm^2/s,（1.72±0.23）×10^（-3）mm^2/s,（1.24±0.11）×10^（-3）mm^2/s in low-risk, moderate-risk and high-risk groups. Significant differences were found in the tumor diameter, intra-tumor necrosis and apparent diffusion coefficients（P0.05）. Conclusion CT and MRI examination contributes to the evaluation of the predilection site of GIST and the diagnosis of benign or malignancy, instructing clinical treatment and estimating prognosis.