胃肠道间质瘤的MSCT及MRI临床诊断价值

Diagnostic value of MSCT and MRI in gastrointestinal stromal tumor

目的探讨MSCT及MRI在胃肠道间质瘤中临床诊断价值。方法回颐性分析本院2010年4月至2017年8月期间18例胃肠道间质瘤患者，其中行MSCT检查17例，行MRI检查1例，与手术及病理结果进行对照，分析MSCT及MRI影像表现与肿瘤危险性关系。结果18例患者中总共21个肿块，其中中-高危患者9例，肿瘤最大直径〉5cm，形态不规则，合并坏死6例（6／9）、溃疡4例（4／9）、出血及囊变3例（3／9）及钙化3例（3／9）；CT增强表现为不均匀轻度一中度强化5例，重度强化3例；MRI表现为T2WI稍高信号为主混杂信号l例，并TIWI加权图像上强化不均匀；2例高危间质瘤术后l-2年发生转移。低危类型9例，肿瘤最大直径〈5cm，呈圆形及类圆形，边缘光整、形态规则，平扫密度均匀并增强后轻一中度强化。结论胃肠道间质瘤CT及MRI表现具有一定的特征性，肿瘤大小、形态及密度（信号）、数目及周围浸润情况、生长方式对GIST危险性判断具有诊断价值。

Objective To explore the value of MSCT and MRI in the diagnosis of gastrointestinal stromal tumors （GIST）. Methods In 18 cases of GIST from our hospital from April 2010 to August 2017, 17 cases received MSCT scan and 1 case received MRI scan. The MSCT and MRI imaging were compared with surgery and pathology results to analyze the risk. Results A total of 21 tumour were found in 18 patients, 9 cases were medium-high risk, the tumor maximum diameter was greater than 5 cm, the tumor was irregular, there were 6 cases of necrosis, 4 cases of ulcer, 3 cases of hemorrhage and cystic change, 3 cases of calcification; CT showed 5 cases of inhomogeneous slight-moderate enhancement, 3 cases of marked enhancement; I cases of high-risk GIST in signal intensity was demonstrated mostly as non-uniform signal on T2WI and T1WI inhomogeneous enhancement clutter; 2 cases of high-risk GIST had metastasis within 1-2 years after operation. In 9 cases of low risk GIST, the tumor maximum diameter was less than 5 cm, all lesions were oval-shaped and well-defmed, the lesions appeared homogeneous density, which were slight-moderate homogeneous enhancement. Conclusion Certain characteristic CT and MRI findings could be assessed in gastrointestinal stromal tumor, CT and MRI findings with pathologic correlation type and tissue components, may suggest the risk of GIST.