胃肠道间质瘤的多层螺旋CT诊断

目的提高对胃肠道间质瘤(GIST)的认识和影像学诊断水平。方法回顾性分析17例GIST的临床及多层螺旋CT(MSCT)资料。结果病灶分布于胃11例,十二指肠1例,空肠1例,回肠1例,结肠1例,直肠2例;肿瘤平均直径5.5cm。病理分型:良性5例,交界性2例,恶性10例。CT主要表现为圆形或类圆形软组织肿块,具有跨越腔内外生长或以腔外生长为主特性。良性5例,直径均小于5cm,平扫密度均匀,增强扫描肿块明显均匀强化。恶性及交界性GIST中有8例直径大于5cm(8/12),肿块不规则,密度不均匀,增强后肿块不均匀强化,内部出血、坏死、囊变明显,局部淋巴结无转移。结论 GIST是一类潜在恶性的肿瘤,MSCT检查对GIST的定位、定性诊断及治疗方案的制定具有重要作用。

CT diagnosis of gastrointestinal stromal tnmors

Objective To review the CT features of benign and malignant gastrointestinal stromal tumor as an aid to diagnosis. Methods Clinical and imaging data of 17 patients with gastrointestinal stromal tumors were analyzed retrospectively. Results The tumors were located in the stomach （n=11）, duodenum （n=1）, jejunum （n=1）, ileum （n=1）, colon （n=1） and rectum （n=2）. The mean diameter of tumors was 5.5 cm. Of the 17 cases, 5 were benign, 2 borderline and 10 malignant. All of the tumors were partly or totally exophytic. The five benign tumors with mean diameter 〈 5cm were spherical with homogeneous CT density and contrast enhancement. Eight of the 12 borderline and malignant tumors were larger than 5 cm with irregular shapes and heterogeneous density. After intravenous administration of contrast agent, tumors enhanced heterogeneously with hemorrhage, necrosis and cysts. No metastatic lymph nodes were found. Conclusion Spiral CT is helpful in differentiating malignant from benign gastrointestinal stromal tumors.