胃肠道间质肿瘤的影像表现

Imaging representation of gastrointestinal stromal tumors

目的 探讨钡餐造影和CT对胃肠间质肿瘤 (GIST)的诊断价值。方法 13例经手术病理证实的GIST均行胃肠钡餐造影检查 ,其中 11例行CT检查 ,对其影像学表现进行分析。结果13例中发病部位位于空肠者 6例 ;良性间质肿瘤 5例 ,恶性间质肿瘤 8例 ;4例伴肠系膜淋巴结转移。钡餐造影表现为黏膜皱襞变平或破坏 12 (12 / 13 )例 ,肠腔偏侧性狭窄 7(7/ 13 )例 ,肿块内出现钡斑或窦道样改变 4(4/ 13 )例。CT表现为腔外不规则或分叶状肿块 10 (10 / 11)例 ,肿块内出现明显的多灶性低密度坏死区 6(6/ 11)例 ,增强扫描有明显的不均匀性强化。结论 钡餐造影和CT是定位诊断的主要影像学方法 ,沿小肠长轴发展的偏侧性肠腔狭窄、伴有多发性溃疡或 (和 )

Objective To evaluate the imaging diagnostic value in gastrointestinal stromal tumors (GIST). Methods Barium sulfate study and CT manifestations in 13 cases of GIST verified by operation and pathology were retrospectively analyzed. Results The most frequent location of the disease was at jejunum (6/13). The tumors included 5 benign stromal tumors and 8 malignant stromal tumors. 4 cases were found to have mesenteric lymph nodes metastasis. The main signs of barium meal included flattened or destroyed mucosa rugae (12/13), partial lumen stenosis (7/13), and barium fleck and fistula in the tumor (4/13). Lobulated or irregular protrusions out of the lumen (10/11), multifocal low density necrosis in the tumor (6/11), and marked inhomogeneous enhancement were common features on CT scanning. Conclusion GIST is not rare. It is necessary for the radiologists to pay attention to the problem. Barium examination and CT scan are the major imaging techniques in the determination of the location of GIST. The appearance of imperfect bowel lumen and the irregular tumor with multi ulcerations or low density regions may lead to the correct diagnosis.