不同病理危险分级胃肠道间质瘤增强CT影像学征象研究

Enhanced CT Imaging Signs of Gastrointestinal Stromal Tumors of Different Pathological Risk Classification

目的分析不同病理危险分级胃肠道间质瘤(gastrointestinal stromal tumor,GISTs)增强CT影像学征象。方法选取2017年7月至2019年11月本院收治的66例GISTs患者作为研究对象,分析不同病理危险GISTs的CT征象之间的差异。结果不同危险度GISTa患者肿瘤位置以胃部多见,生长方式以腔外生长为主。低度与中度危险GISTa患者肿瘤边界多清晰,直径以≤5cm病灶多见,密度不均匀,增强扫描以中度强化多见,肿瘤内多无血管显示,与胃肠道不相通。重度危险GISTa患者肿瘤边界较模糊,病灶直径都>5cm,CT扫描密度多不均匀,增强扫描可见中度-明显强化,肿瘤内有血管显示,与胃肠道多不相通。低、中、重度危险GISTa在肿瘤边界、直径、密度、血管显示及与胃肠道关系方面比较有明显差异(P<0.05),而在肿瘤位置、生长方式、各时期CT值及强化程度上比较无明显差异(P>0.05)。结论不同危险GISTs的CT征象具有一定差异,充分掌握了解其CT征象,综合患者资料可准确评估其恶性程度,为临床治疗与评估患者预后提供指导意见。

Objective To analyze the enhanced CT imaging signs of gastrointestinal stromal tumors(GISTs)of different pathological risk classification.Methods 66 patients with GISTs admitted in our hospital from July 2017 to November 2019 were selected as the research subjects to analyze the differences in CT signs of GISTs of different pathological risks.Results The tumor of patients with GISTa in different risks is more common in the stomach,mainly grew outside cavity.GISTa patients in low and moderate risks have clear boundaries of tumor.Lesions with diameter≤5cm are more common.Density is not uniform,and enhanced scans are more common with moderate enhancement.Most of the tumors show no blood vessels,showing no connection with the gastrointestinal tract.In patients with GISTa in severe risk,the borders of tumors are blurred.The diameters of the lesions are>5cm.The CT scan shows uneven density,and the enhanced scan shows moderate-significant enhancement.There are blood vessels in the tumor,showing that it is not connected with the gastrointestinal tract.There are significant differences in tumor boundaries,diameter,density,vascular display,and relationship with the gastrointestinal tract between GISTa in low,moderate,and severe risk(P<0.05),but there is no difference in tumor location,growth mode,CT value and enhancement degree at each stage(P>0.05).Conclusion The CT signs of GISTs in different risk have some differences.Fully understanding its CT signs and combining with clinical data of patients can accurately assess its degree of malignancy,which provide guidance for clinical treatment and evaluation of prognosis of patients.