胃肠道恶性间质瘤的CT表现与病理对照  

CT findings of malignant gastrointestinal stromal tumors and their correlation with pathology

作　　者：胡茂清[1] 龙昉[1] 张朝桐[1] 罗学毛[1] 金志发[1] 龙晚生[1] 

机构地区：[1]广东省江门市中心医院放射科,广东江门529030

出　　处：《实用医学影像杂志》2008年第5期300-302,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨恶性胃肠道间质瘤(MGIST)的CT表现及其与病理的相关性。方法回顾性分析经手术病理证实的21例MGIST的CT表现并与手术病理对照。结果21例MGIST均为单发,发病部位包括胃11例,小肠7例,直肠3例。根据MGIST的形态与生长方式可将其CT表现分为4型:腔外型9例,腔内型3例,腔内外型4例,以及厚壁型5例。肿瘤直径小于5cm者5例,而大于5cm者16例。除2例肿瘤表现为均匀密度外,其余19例肿瘤为不均匀密度,伴有明显坏死、囊变及不规则形或分叶状边缘。增强扫描肿瘤呈中度或显著不均匀强化。瘘道形成与瘤内钙化各见于2例。CT扫描发现肝转移2例,网膜转移1例及伴发肠梗阻2例。结论MGIST随其生长方式而有不同的CT表现,而这些影像特征有助于提高其诊断准确性。Objective To investigate the CT findings of malignant gastrointestinal stromal tumors （MGISTs）and their correlation with pathology.Methods CT findings of 21 patients with surgically and pathologically proved MGIST were analyzed retrospectively and compared with pathology.Results All the patients were found to have single MGISTs which comprised 11 in the stomach,7 in the small intestinum,and 3 in the rectum.According to the tumor shape and growth pathern, MGISTs in 21 patients could be divided into following four types：extra-cavity（n=9）,intra-cavity （n=3）,mixed （n=4）,and thickening wall （n=5）.The tumor diamter in 5 cases was less than 5 cm while that in 16 cases was more than 5 era.Except 2 eases whose tumors were homogeneous density,other 19 eases whose tumors were nonhomogeneous density and associated with necrosis,cystic change and irregular or lobulated margin.After contrast enhaneement,MGISTs were middle-or obviously nonhomogenous enhancement.The fistula formation and intratumoral calcification were found in 2 cases,respeetively.CT scans showed hepatic metastasis in 2 cases,omental metastasis in 1 ease,and intestinal obstruction in 2 eases.Conclusion MGISTs with their growth patterns have different CT findings which are helpful to improve the diagnostic accuracy.

关 键 词：胃肠道间质瘤 恶性 CT分型 病理 体层摄影术 X线计算机 

分 类 号：R735[医药卫生—肿瘤]