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华西医学  2011 

胃肠道间质瘤的螺旋CT诊断价值

, PP. 698-701

Keywords: 胃肠道间质瘤,体层摄影术,CT

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Abstract:

【】　目的　分析胃肠道间质瘤（gastrointestinalstromaltumors，GIST）的螺旋CT（multi-detectorrowspiralcomputeelTomography，MSCT）表现，评价其对该病的诊断价值。　方法　回顾性分析2000年3月―2010年10月经手术病理证实的32例GIST的MSCT表现，并将其与病理的生物学危险性进行对比研究。　结果　病理高、中、低及极低危险性GIST依次为15、6、7、4例。GIST主要CT表现，肿块腔外生长为主，大部分病灶边界清楚，呈类圆形或分叶状，密度均匀或不均匀，3例可见钙化，GIST增强静脉期强化较动脉期更明显，局部均无淋巴结转移，转移到肝脏的4例，同时伴前腹壁转移1例。15例肿块长径≥5cm，密度多不均匀，可有囊变、坏死、出血等，增强不均匀强化，其中11例病理为高风险性；17例肿块长径<5cm的病灶中，大多中度均匀强化，其中13例为中度及以下危险性。　结论　GIST患者的MSCT表现具有一定的特征性，MSCT对准确定位、术前估计肿瘤的风险级别、术后随访有重要价值。【Abstract】　Objective　Toinvestigatetheimagingfeaturesofmulti-slicespiralCT(MSCT)forgastrointestinalstromaltumors(GIST)anditsdiagnosticvalue.　Methods　WeretrospectivelyanalyzedtheMSCTmanifestationsof32casesofGISTconfirmedbyoperationandpathologybetweenMarch2000andOctober2010.ComparativestudywasthencarriedoutbetweenMSCTmanifestationsandpatho-physiologicalrisks.　Results　Ofthe32GISTlesions,15presentedwithhighbiologicalrisks,sixmoderaterisks,sevenlowrisksandfourverylowrisks.TheMSCTresultsmanifestedthefollowingmainfeatures.Exophyticgrowthwaspredominating;Mostlesionswerewithwell-definedmargins,andwererotundorlobularinshapewithhomogeneousorheterogeneousdensity.Threelesionsmanifestedcalcification.TheenhancementdegreeofGISTinportalveinphasewasmoreobviousthaninarterialphase.Therewasnometastasistolocallymphnodes.Hepaticmetastasisoccurredinfourcases,oneofwhichwasaccompaniedwithanteriorabdominalwallmetastasis.Ofthe15lesionswithmaximaldiameterlongerthan5cm,MSCTshowedobviouscysticchanges,necrosisorhemorrhagewithinthemassmostofwhichwasinheterogeneousdensity,andheterogeneousenhancement;Elevenoutofthe15lesionswereathighrisk.Amongthe17lesionswithmaximaldiametershorterthan5cm,MSCTshowedhomogeneousenhancement,and13ofthemwereatmoderateriskorbelow.　Conclusion　TheMSCTimagingofGISTmanifestssomecertaincharacteristics.Itisvaluableinlocatingthelesionprecisely,estimatingtherisklevelofthetumor,andpostoperativefollow-upforpatientswithGIST.

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