【摘要】 目的 探讨胃肠道间质瘤的CT表现。方法 分析手术病理证实的32例胃肠道间质瘤的CT表现,并将大体病理所见与CT表现对照。结果 位于食管1例,胃7例,小肠12例,结肠5例,肠系膜4例,由于肿瘤巨大,不能分辨来源1例,多发2例,起自胃肠道及其系膜。肿瘤最小1.5 cm×1.5 cm×1.0 cm,最大约45 cm×45 cm×32 cm。32例中恶性21例,潜在恶性6例,良性5例。肿瘤平扫密度不均匀,2例可见钙化。17例肿瘤与周围脏器分界不清;增强扫描根据肿瘤的强化方式,分3种类型:Ⅰ型,动脉期大致均匀强化,延迟扫描肿瘤全部强化,静脉期强化略高于动脉期。Ⅱ型,肿瘤实性部分结节状强化,结节之间可见线状低密度影。Ⅲ型,动脉期肿瘤周边线状强化,静脉期强化范围增大,呈“花环状”,延迟扫描肿瘤中心低密度区仍无强化。结论 CT表现与大体病理标本有很好的相关性,在GIST的诊断、分期及随访中很有价值,但确诊仍需免疫组化检查。更多还原

【Abstract】 Objective To investigate CT findings of gastrointestinal stromal tumors(GIST).Methods CT findings of GIST proved by pathology in 32 cases were analysed and compared with that of pathology.Results The lesions located at esophagus in 1case,stomach in 7,intestine in 12,colon in 5,mesentery in 4,undifferentional in 1,multiple locations in 2 cases which origined from gastrointestinal tract and mesentery.The tumors ranged from 1.5 cm×1.5 cm×1.0 cm to 45 cm×45 cm×32 cm in size.Tewtyone were malignant,6 were potentially malignant and 5 were benign in the total 32 cases.In plain CT scan,the density of tumors was homogeneous,in which 2 cases accompanied with calcification.The margins of the tumors were unclear in 17 cases.There were 3types of contrast enhancement patterns after contrast agent in venous injection,type Ⅰ was almost homogeneous enhancement in the arterial phase and then whole tumor enhanced,the tumors had slightly stronger enhancement in venous phase than arterial phase;typeⅡ showed nodular enhancement in the solid part of the tumors and there was linear low density between the nodus;type Ⅲ showed linear contrast enhancement in peripheral part of the tumors in arterial phase,and the enhanced area became enlargement and liked a "wreath" in the venous phase.The central part of the tumors kept low density due to no contrast enhancement.Conclusion CT and pathological specimens findings of GIST have a very good correlation,CT examination is of greatly value in diagnosing staging and following-up GIST,but the confirmed diagnosis relies on the immunohistochemistry.更多还原