CT和双对比造影诊断胃肠道间质瘤的价值分析  

Analysis of the Value of CT and Double Contrast Radiography in Diagnosing Gastrointestinal Stromal Tumors

作　　者：钱民[1] 李小荣[1] 朱俭[2] 林伟光[1] 欧陕兴[1] 

机构地区：[1]广州军区广州总医院放射科,510010 [2]南方医科大学附属珠江医院放射科,510282

出　　处：《临床放射学杂志》2005年第12期1084-1087,共4页Journal of Clinical Radiology

摘　　要：目的探讨CT和双对比造影对胃肠道间质瘤(GIST)的诊断价值。资料与方法回顾分析28例经手术病理证实为GIST的影像及临床资料,28例均行CT检查,13例行双对比造影检查。结果28例GIST主要CT表现为:良性6例,肿块直径≤5cm,边界清楚,密度均匀,呈轻度均匀性强化。恶性22例,有如下特征:(1)肿块直径≥5cm17例;(2)肿块内出现低密度坏死20例;(3)肿瘤实体明显强化,增强前后净增加CT值≥40HU18例;(4)瘤体内和瘤旁伴有成簇状或线状排列血管影15例;(5)周围组织侵犯或远处转移12例。13例胃肠造影表现为胃肠道腔内圆形或椭圆形充盈缺损,边缘光整,黏膜皱襞变平或消失,瘤周黏膜呈推移改变。本组CT定位准确性为67.86%(19/28),双对比造影为76.92%(10/13)。对良、恶性的鉴别:CT准确性为78.57%(22/28),双对比造影为50%(5/10);另3例腔外型被误认为外压性改变。结论胃肠道双对比造影是检查GIST最基本的方法,CT和双对比造影结合有助于对GIST术前定位和定性诊断。Objective To evaluate the diagnostic value of CT and double contrast radiography of gastrointestinal tract in gastrointetinal stromal tumor （GIST）. Materials and Methods Imaging features of 28 patients with GIST proved by surgically and pathologically were retrospectively analyzed. CT were performed in all 28 cases and double contrast radiography in 13 cases. Resuits The main CT features of 28 cases were： 6 cases were benign, which were less than 5cm in diameter, having clear margin and homogeneous density with slightly homogeneous enhancement. 22 cases were malignant, the characteristic appearances were as following ： （ I ） The diameter of the tumor was more than 5era （17/22） ; （2） Lesions contained necrosis with low density （20/22） ; （3） masses were enhanced markedly, CT value was increased more than 40 HU after enhancement（18/22） ; （4） In and around the tumor, small vessels arranged in clumps or in llne（15/22） ; （5）Invasion of adjacent tissues and metastasis （12/22） . 13 imaging feature of double contrast radiography were included intraluminal circular or ellipse filling defect, the border were well-defined, mucosal rugae flattered ordisappeared, displaced of periphery mucosal of mass due to compression. The accuracy of CT for location was 67.86% （19/28）, double contrast radiography was 76.92% （10/13）. The accuracy of differentiating benign from malign of CT was 78.57% （22/28）, and double contrast radiography was 50% （5/10）, tumors of extraluminal type were identified incorrectly as outside compression in another 3 cases. Conclusion Double contrast radiography of gastrointestinal tract is the primary method in diagnosing gastrointetinal stromal tumors, CT combined with double contrast radiography are helpful in evaluating the gastrointestinal origin of GIST, and in differentiating between benign and malignant GIST before operation.

关 键 词：胃肠道 间质瘤 双对比造影术 体层摄影术 X线计算机 

分 类 号：R735[医药卫生—肿瘤]