摘要
目的探讨256层螺旋CT在诊断胃肠间质瘤(GIST)中的影像表现,以提高对本病的诊断准确率。方法回顾性分析2015年10月至2017年11月经手术病理证实的GIST 36例,均行CT平扫和增强扫描。CT征象评估包括肿瘤的大小、轮廓、表面形态、边缘、生长方式、增强方式及程度。结果 GIST发生于胃部(胃底、胃窦、胃体)28例,空回肠7例,结肠降部1例。良性16例,潜在恶性6例,恶性14例。肿块生长方式主要为腔外生长(52.8%,18/36),其次为腔内型(27.8%,10/36)及跨壁腔内外型(22.2%,8/36)。大体形态呈类圆形或类椭圆形肿块29例,分叶状或不规则肿块8例。CT平扫27例瘤体呈均匀密度;肿块周边呈等密度,呈不均匀密度者9例,5例可见钙化,4例黏膜面溃疡形成,其中1例瘤内积气。增强扫描病灶中等至明显强化者20例;15例瘤体强化密度不均匀,内见囊变坏死。淋巴结转移1例。CT影像诊断GIST良恶性总体符合率为66.7%(24/36)。CT定性准确率66.7%(24/36),定位准确率100%(36/36)。结论 GIST是一种黏膜下起源的肿瘤,其CT影像表现有一定特征性,对该病诊断和鉴别诊断有重要意义。
Objective To investigate the image manifestation of 256-slice spiral CT in the diagnosis of gastrointestinal stromal tumor (GIST) in order to improve the accuracy rate of diagnosis. Methods A total of 36 GIST patients who were confirmed by surgical pathology from October 2015 to November 2017 were analyzed retrospectively. All the patients were received plain and enhanced CT scanning. CT signs included tumor size, contour, surface morphology, margin, growth pattern and the pattern and degree of enhancement. Results GISTs were found in 28 cases of stomach ( including fundns, antrum and body) , 7 cases of jejunum and 1 case of descending colon. There were 16 cases of benign, 6 cases of potential malignant and 14 cases of malignant. The main growth pattern of GIST was extra-luminal growth ( 52.8% , 18/36 ) , followed by intra-luminal growth (27.8%, 10/36) and transmural growth (22. 2%, 8/36). There were 29 cases of oval or elliptic mass and 8 cases of lobulated or irregular mass in gross morphology. In plain CT scanning, there were 27 cases that tumor body was homogeneous density, 9 cases that the periphery of tumor was homogeneous density while the tumor body was nonhomogeneous density, 5 cases that calcification was seen, 4 cases that ulcer was formed at mucosal surface and 1 case of tumor accumulation. In enhanced CT scanning, there were 20 cases that lesion was enhanced moderately to significantly, 15 eases of nonhomogeneous density in tumor body with necrosis and cyst degeneration and 1 case oflymphatic metastasis. The overall coincidence rate of CT imaging in the diagnosis of GIST was 66. 7 % (24/36) , while the accuracy rate of CT was 66. 7% ( 24/36 ) and the accuracy of localization was 100% ( 36/36 ). Conclusion GIST is a tumor originating from submucosa, and its CT imaging features have certain characteristics, which has great significance for the diagnosis and differential diagnosis of GIST.
作者
白卓杰
王秀锦
王小进
卜顺林
黄敏
王国兰
BAI Zhuo-jie;WANG Xiu-jin;WANG Xiao-jin;BU Shun-lin;HUANG Min;WANG Guo-lan(Department of Radiology, Nanjing Jiangbei People's Hospital Affiliated to Nantong University, Nanjiag, Jiangsu 210048, China)
出处
《中国临床研究》
CAS
2018年第6期833-836,共4页
Chinese Journal of Clinical Research
基金
南京医学科技发展项目(QRX17096)