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目的:探讨多排螺旋CT对胃肠道间质瘤的诊断及鉴别价值。方法:对本院经手术和病理证实的35例胃肠道间质瘤患者的CT影像资料进行回顾性分析。结果:35例均为单发,位于胃部20例、十二指肠3例、空肠5例、回肠3例、小肠系膜2例、食管1例、直肠1例。病灶最大径2.3～16.5 cm,13例体积较小(<5.0 cm),多呈类圆形(84.6%,11/13),密度均匀(92.3%,12/13),境界清(100%,13/13),增强后轻中度均匀强化;22例体积较大(>5.0 cm),多呈不规则分叶状(86.4%,19/22),密度不均匀(90.9%,20/22),中心可见囊变坏死区(81.8%,18/22),少数可见出血(13.6%,3/22)、溃疡(13.6%,3/22)及钙化(9.1%,1/22),可直接侵犯周围结构(31.8%,7/22)及伴有远处转移(27.3%,6/22),增强后不均匀中度至明显强化,部分病灶内或瘤旁可见增粗供血动脉。结论:多排螺旋CT平扫及增强扫描显著提高了胃肠道间质瘤的检出率和诊断准确性,对胃肠道间质瘤的诊断及鉴别具有重要价值。
Objective: To investigate the value of multislice spiral CT in the diagnosis and differential diagnosis of gastrointestinal stromal tumors. Methods: The CT images of 35 patients with gastrointestinal stromal tumors confirmed by surgery and pathology were retrospectively analyzed. Results: All the 35 cases were single. There were 20 cases in stomach, 3 cases in duodenum, 5 cases in jejunum, 3 cases in ileum, 2 cases in small mesentery, 1 case in esophagus and 1 case in rectum. The lesions ranged from 2.3 cm to 16.5 cm in diameter with 13 cases being smaller (<5.0 cm), mostly round (84.6%, 11/13), with uniform density (92.3%, 12/13) (> 13.0 cm), with irregular lobulation (86.4%, 19/22), uneven density (90.9%, 20/22 (81.8%, 18/22) in the center, and a few were found to have hemorrhage (13.6%, 3/22), ulcers (13.6%, 3/22) and calcification (9.1%, 1/22) Directly infringe the surrounding structures (31.8%, 7/22) and associated with distant metastasis (27.3%, 6/22), enhanced uneven to moderately enhanced, partial thickening of the lesion or tumor can be seen around the artery. Conclusion: Multi-slice spiral CT scan and enhanced scan significantly improve the detection rate and diagnostic accuracy of gastrointestinal stromal tumors, gastrointestinal stromal tumors of the diagnosis and identification of great value.