多层螺旋CT双期扫描对胃肠道间质瘤的诊断  

Diagnostic Value of Two-phase Multi-slice Spiral CT in Gastrointestinal Stromal Tumor

作　　者：张华[1] 李锡林[1] 侯勤明 陆映宏 虞慧灵 

机构地区：[1]浙江省建德市第一人民医院放射科,浙江建德311600

出　　处：《实用放射学杂志》2011年第3期401-403,412,共4页Journal of Practical Radiology

摘　　要：目的 探讨胃肠道间质瘤（GIST）的多层螺旋CT征象及其诊断价值.方法 回顾性分析经手术病理证实的22例GIST的平扫及双期增强多层螺旋CT征象.结果 肿瘤位于胃部11例,小肠5例,发生于结直肠5例,肠系膜内1例,CT定位诊断符合率为86%（19/22）.良性4例,潜在恶性4例,恶性14例.肿块多呈圆形或类圆形,黏膜下型4例,浆膜下型5例,肌壁间型12例,胃肠道外型1例.黏膜下富血供肿瘤,倾向腔外生长,大多数密度不均匀,内部可发生囊变或坏死,少部分见出血、钙化及气体影.肿瘤实质部分大多中等至明显强化,静脉期进一步强化.结论 GIST双期增强表现具有一定特点,能准确显示肿瘤的部位、形态、大小,对肿瘤诊断及良恶性诊断有重要价值.Objective To investigate multi-slice spiral CT features of gastrointestinal stromal tumor（GIST） and its diagnostic value. Methods Plain and two-phase dynamic contrast-enhanced CT features in 22 cases with GIST proved by surgery and pathology were retrospectively analysed. Results The tumors originated from stomach （ n = 11 ）, small bowel （ n=5 ）, colorectum （ n = 5 ） and mesentery（n= 1）. The accurate rate in localization of GIST with CT was 86 % 119/22 ）. 22 cases included benign （ n = 4 ）, potential malignancy （n= 4） and malignancy（n=14）. The tumors were mainly round or oval in shape, there were 4 types including sub-mucosa （ n = 4 ）, subserosa（ n= 5 ）, myo-intramural （ n = 12 ） and extra-gastrointestinal （ n = 1 ）. The tumors with abundant vascularity at sub- mucosa tended to exoluminal growth, most tumors showed cystic degeneration or necrosis,a part of cases showed haemorrhage, calci- fication and gas inside the tumors. The solid parts of most tumors enhanced moderately to markedly after the contrast media adminis- tered and further enhancement during venous phase. Conclusion Two-phase multi-slice spiral CT examination in GIST has certain characteristic,CT can detect the location, shape and size of tumors, and it is of important value in the diagnosis and differentiating the benign from malignant tumors.

关 键 词：腹部 胃肠道间质瘤 体层摄影术 X线计算机 

分 类 号：R735.2[医药卫生—肿瘤] R735.3[医药卫生—临床医学]