胃肠道间质瘤的64排螺旋CT表现及病理分析

CT Manifestations and Pathological Analysis of 64 Slice Spiral CT in Gastrointestinal Stromal Tumors

目的:分析64排螺旋CT在胃肠道间质瘤的CT表现,与病理结果相对比,以此来评价CT在临床诊断中的应用价值。材料与方法:回顾性分析经手术及病理证实的18例胃肠道间质瘤的64排螺旋CT影像表现并对病理结果分析。结果:18例胃肠间质瘤位于胃部6例,空肠6例、回肠4例,2例位于腹膜后、盆腔,肿块最大径范围2.0-19cm。18例中平扫肿瘤呈实性软组织肿块5例,13例肿瘤呈密度不均匀,合并囊变、坏死。18例中3例合并瘤内出血,2例病灶有散在点、片状钙化。18例增强扫描5例肿块均为均匀强化;13例呈不均匀性强化,周边强化峰值增高,尤以静脉期显示明显。18例中出现肝脏、腹膜转移5例,腹膜后淋巴结转移1例。结论:胃肠道间质瘤的64排螺旋CT表现有一定的特征性,对肿瘤的良恶性有一定帮助,为临床术前制定治疗方案、判断预后有很大的指导意义。64排螺旋CT可做为胃肠道间质瘤的首选影像检查方法。

Purpose： To analyze 64 slices spiral CT manifestation of gastrointestinal stromal tumors and compared with the pathological results,to evaluate the value of CT in clinical diagnosis of gastrointestinal stromal tumors. Materials and Methods： 64 slice spiral CT imaging findings of 18 patients with gastrointestinal stromal tumors confirmed by surgery and pathology were analyzed retrospectively. Results： 18 cases of gastrointestinal stromal tumors were located in the stomach 6 cases,jejunum 6 cases,ileum 4 cases,and 2 cases in retroperitoneal and pelvic cavity. The maximum diameter of the tumor was2. 0- 19 cm. 18 cases of tumors showed soft tissue mass in 5 cases,13 cases showed heterogeneous density with cystic degeneration and necrosis. In 18 cases,there were 3 cases of tumor hemorrhage,and 2 cases were scattered in the spot and calcification. In 18 cases of enhanced scan,5 cases of tumors were homogeneous enhancement and 13 cases showed uneven enhancement,peripheral enhancement peak increased,especially in the venous phase. In 18 cases,there were 5 cases of liver and peritoneal metastasis,1 cases of retroperitoneal lymph node metastasis. Conclusion： Gastrointestinal stromal tumors of the64 row spiral CT has a certain characteristic,the benign and malignant tumor has a certain help for the clinical development of preoperative treatment plan,to determine the prognosis of a great guiding significance. 64 slice spiral CT can be used as the first choice of imaging examination for gastrointestinal stromal tumors.