多层螺旋CT对胃肠道间质瘤的诊断价值及临床病理分析  

Diagnostic value of MSCT in gastrointestinal stromal tumor and the clinic-pathology analysis

作　　者：徐利军[1] 文阳[1] 王伯胤[1] 王伟[2] 

机构地区：[1]浙江省绍兴市人民医院影像科,浙江绍兴312000 [2]浙江省绍兴市人民医院病理科,浙江绍兴312000

出　　处：《医学影像学杂志》2009年第2期165-168,共4页Journal of Medical Imaging

摘　　要：目的：分析胃肠道间质瘤（GIST）的CT表现及临床病理特点,评价MSCT对该肿瘤的诊断价值。方法：回顾性分析38例手术病理证实的胃肠道间质瘤患者的MSCT及病理资料。结果：38例GIST发生在胃18例,小肠14例,食管和直肠各1例;良性12例（9例发生在胃）,潜在恶性6例（胃4例,小肠2例）,恶性20例（胃9例,小肠11例）;良性者知径1-5cm,密度均匀,增强均匀强化（10/12）,恶性肿块直径6-19cm,内可见变性坏死、囊变形成灶性低密度区,并呈不均匀强化（20/24）。本组对GIST的定位和定性准确率分别为92.1%（35/38）和89.4%（34/38）。免疫组化CD117和CD34阳性表达者32例,6例CD117或者CD34阳性。结论：MSCT检查在显示GIST的部位、形态、大小和内部结构,以及初步鉴别肿瘤良恶性上具有重要临床价值。Objective：To evaluate the imaging diagnostic value of MSCT in gastrointestinal stromal tumor（GIST） through discussing the MSCT features and pathologic characteristics of GIST. Methods： Thirty eight cases of GIST confirmed by surgery and pathology with inte- grated CT and pathologic data were analyzed retrospectively. Results：Among total 38 cases of GIST, 18 lesions were located in stomach, 14 in small bowel, 1 in esophagus and 1 in rectum; 12 cases were benign（9 lesions in stomach）, 7 cases were potential malignant （4 lesions in stomach and 2 lesions in small bowel）, 20 cases were malignant （9 lesions in stomach and 11 lesions in small bowel）; In benign GIST, the tumor diameters were always less than5 cm. The lesions were homogeneously attenuating and homogenous enhancement on contrast enhanced CT scans （10/12）. In malignant GIST, the tumor diameters were always larger than 5 cm. Imaging findings of the lesions were heterogeneous density and inhomogeneous enhancement, corresponding to necrosis and cystic changes （20/24）. Accuracy rates of CT diagnosis for localizing and differentiating the benign or malignancy of GISTs were 92.1% （35/38） and 89.4% （34/38）, respectively. Immunohistochemical analysis shows CDl17 and CD34 all positive expressed in 32 cases, and 6 eases positive either CD117 or CD34. Conclusion：MSCT scans have great clinic value in providing information regarding location, shape, size, internal structure and preliminary identifing of benign and malignant tumors.

关 键 词：胃肠间质瘤 体层摄影术 X线计算机 免疫组织化学 

分 类 号：R735[医药卫生—肿瘤] R814.42[医药卫生—临床医学]