胃肠道间质瘤的临床及影像学表现

The clinical and imaging findings of gastrointestinal stromal tumors

目的 :提高对胃肠道间质瘤 (GISTs)的认识和影像学诊断水平。方法 :回顾性分析 3 1例GISTs的临床及影像学资料。结果 :病灶分布于胃 2 2例 ,小肠 7例 ,胃肠道外 2例 ;肿瘤平均直径 6.5cm。病理分型 :良性 6例 ,交界性 7例 ,恶性 18例。临床表现多为腹部不适 ( 18/2 8)、消化道出血 ( 13 /2 8)、腹痛 ( 11/2 8)和消瘦 ( 5 /2 8)。主要影像学表现为粘膜下富血供肿块 ,境界清晰光整 ,外生性为主 ,内部出血、坏死、囊变明显 ,局部淋巴结无转移。结论 :GISTs是一类潜在恶性的肿瘤 ,应手术完整切除。其影像学表现具有一定特征 ,但不能定性 。

Objective:To improve our knowledge and the ability of imaging diagnosis of gastrointestinal stromal tumors (GISTs).Methods:The clinical and imaging data of 31 patients with GISTs were analyzed and summarized. Results: Tumor located in the stomach in 22 cases,small bowel in 7 cases and extragastrointestinal sites in 2 cases.The average size was 6.5cm in diameter.Immunohistochemical study diagnosed as benign in 6 cases, Intermediate in 7 cases and malignant in 18 cases.The common symptoms were vague abdominal discomfort (18/28), gastrointestinal tract bleeding (13/28),abdominal pain (11/28) and weight loss (5/28).The main imaging appearances included submucous hypervascular lesions with well defined margins,predominating exophytic growth,obvious hemorrhage or necrosis and cystic changes within the mass and no metastases to local lymph nodes.Conclusion:All GISTs should be considered a potential malignancy and complete excision is recommended.The relatively characteristic imaging findings may strongly suggest the possibility of GISTs but that is not comfirmatory.The final diagnosis is provided only by immunohistochemical and electron microscopic examination.