【摘要】 目的探讨多排螺旋CT对胃肠道间质瘤(GIST)的诊断价值。方法对12例经手术和病理证实的GIST患者临床及影像学资料进行回顾性分析。12例均行螺旋CT平扫,其中10例加双期增强扫描。结果肿瘤位于胃部7例,大网膜3例,空回肠2例;单发11例,多发1例。良性间质瘤2例,肿瘤直径≤5cm,边界清楚,密度均匀,增强扫描呈均匀中度强化。恶性间质瘤10例,肿瘤直径≥7cm,边缘有分叶,瘤体内有多个小片状坏死或大块坏死及散在分布的细小钙化点,瘤旁常伴成簇状或线状排列的小血管;侵犯周围组织。CT定位准确度为75.0%,良恶性准确度为66.7%。结论多排螺旋CT平扫加增强动态扫描是目前检查GIST的重要方法之一,多平面重组后处理功能能准确显示肿瘤的部位、形态、大小及与周围组织的关系,有利于良恶性的判断,对临床治疗及预后有着重要的指导价值。更多还原

【Abstract】 Objective To investigate the value of multi-detector spiral CT(MDCT)in the diagnosis of gastrointestinal stromal tumors(GIST).Methods The clinical and imaging data of 12 patients with surgically and pathologically proved GIST were analyzed retrospectively.Unenhanced MDCT was performed in all 12 patients,and biphasic contrast enhanced-MDCT in 10 of them.Results Among the 12 patients,7had tumors in stomach,3had tumors in omentum majus,and 2had tumors in jejunum and ileum.In addition,11 patients had single tumors,and 1patient had multiple tumors.In the 2patients with benign GIST,tumors were moderately enhanced,with a diameter of less than or equal to 5cm,clear margin and homogeneous density.In the 10 patients with malignant GIST,tumors invaded the surrounding tissues,with a diameter of greater than or equal to 7cm,lobulated edge,extensive patchy necrosis or massive necrosis and scattered small calcifications in tumor,and small blood vessels arranged in line or cluster around tumor.The accuracy of MDCT was 75.0%for the location of GIST,and 66.7%for the differentiation of benign and malignant GIST.Conclusion The contrast-enhanced dynamic MDCT is one of the important ways to diagnose GIST.Multi-plane reorganization can display the tumor location,shape,size and relationship to surrounding tissues,contribute to the differentiation of benign and malignant tumors,and provide important guidance to the treatment and prognosis of GIST.更多还原