【摘要】 目的探讨胃肠道间质瘤(GIST)CT表现和病理相关性,提高CT对该病诊断准确性。方法回顾性分析18例GIST的CT征象,并与病理对照。结果18例GIST(胃11例,十二指肠1例,空肠2例,回肠1例,肝胃韧带1例,腹膜后1例,乙状结肠系膜1例)。病理诊断良性7例(38.9%),病灶长径1.5～5cm,平均4cm;交界性3例(16.7%),病灶长径3～6.5cm,平均5.8cm;恶性8例(44.4%),病灶长径5～25cm,平均10.3cm。CT表现为大小不等圆形或类圆形分叶状影。其中,原发胃肠道肿瘤15例(哑铃型3例,腔内型4例,腔外型8例),密度均匀9例,病灶直径平均4.5cm,密度不均匀6例,病灶直径平均9cm,胃肠道外肿瘤3例,密度均匀1例,病灶直径平均5cm,密度不均2例,病灶直径平均14.9cm,增强扫描直径小于5cm或良性GIST,强化均匀,直径大于5cm或交界性、恶性GIST,强化不均,内见大小不等不规则或囊状低密度影。与病理学对照,CT判断GIST良恶性符合率为77.8%。结论GIST影像表现与病理特征相关,肿瘤体积较大,密度不均,边界模糊,包膜强化不连续,分叶状生长,是提示恶性间质瘤的重要征象。更多还原

【Abstract】 Objective To study the correlation between CT findings and pathology of gastrointestinal stromal tumors(GIST) and to elevate the diagnostic accuracy.Methods CT findings of 18 GIST patients were retrospectively analyzed and compared with pathology.Results Among 18 patients,the locations of GIST included stomach(n=11),duodenum(n=1),jejunum(n=2),ileum(n=1),hepatogastric ligament(n=1),retroperitoneum(n=1),and sigmoid mesentery(n=1);the pathologic natures of GIST included 7(38.9%) benign GIST which ranged in diameter from 1.5 cm to 5 cm(the mean,4.0 cm),3(16.7%) precancerous GIST which ranged in diameter from 3.0 cm to 6.5 cm(the mean,5.8 cm),and 8(44.4%) malignant GIST which ranged in diameter from 5.0 cm to 25 cm(the mean,10.3 cm).On CT images,GIST appeared as round or oblong-lobulated shadows,of them,15 cases of primary GIST(3 dumbbell-form,4 intraluminal type and 8 extraluminal type) in whom 9 were homogeneous density and 6 were heterogeneous density;3 cases of GIST originated from the outside of gastrointestinal tract were found to be homogeneous and nonhomogeneous density in 1 and 2 cases,respectively.Following contrast-enhanced CT scans,benign GISTs were homogeneous enhancement while precancerous and malignant GISTs were heterogeneous enhancement and associated with intratumoral irregular or cystiform shadows with varied size and hypodensity.Compared with pathology,the corresponding rate of CT in differentiating benign from malignant GIST was 77.8%(14/18).Conclusion CT findings of GIST are close relation with pathologic nature,bigger tumor,heterogeneous density,ill-definite margin,noncontinuously enhanced capsule and lobulated growth are important signs for suggesting malignant GIST.更多还原