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[目的]分析胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的CT表现并探讨对肿瘤恶性的预测价值。[方法]回顾性分析和评估经病理组织学检查和免疫组化检测证实为胃的GIST患者64例的CT检查影像表现,依照以下CT参数进行了分析:病变位置、大小、形态、边缘、生长方式、静脉对比增强方式、增强强度、邻近器官的侵犯、溃疡、瘘管、钙化、肠系膜脂肪浸润、淋巴结肿大及远处转移的存在,并根据GIST生物学行为进行分级评估与CT表现之间的关系。[结果]肿瘤病变位置多位于胃体(P=0.024);较多表现为外生性生长46%;多表现为中度增强(P=0.000),较少出现邻近器官的侵犯、钙化、肠系膜脂肪浸润、淋巴结肿大及远处转移(均P<0.01);肿瘤大小与生长方式、增强方式均无统计学关联(P>0.05);各侵袭危险性GIST分组在肿瘤大小、形态、生长方式、强化方式、强化强度、肠系膜脂肪浸润、淋巴结肿大、钙化、周围侵犯、转移方面有统计学意义(P<0.05)。[结论]GIST具有特征性的CT影像学表现及临床特征,肿瘤的CT表现与生物学评价具有相关性,掌握其特征对于其诊断、治疗及预后评价具有重要意义。
[Objective] To analyze the CT findings of gastrointestinal stromal tumors (GIST) and to explore the predictive value of malignant tumors. [Methods] The CT findings of 64 cases of GIST confirmed by histopathology and immunohistochemistry were retrospectively analyzed and evaluated. The CT findings were analyzed according to the following CT parameters: lesion location, size, shape, margin, growth Methods: Venous contrast enhancement, enhanced intensity, adjacent organ invasion, ulcer, fistula, calcification, mesenteric fat infiltration, lymphadenopathy and distant metastasis were observed. The relationship between the grading and CT appearances according to the biological behavior of GIST relationship. [Results] Most of the tumor lesions were located in the corpus (P = 0.024). Most of the tumors were exostosis (46%), moderately enhanced (P = 0.000), less infiltration of adjacent organs, calcification, mesenteric fat (P <0.01). There was no significant correlation between tumor size and growth mode and enhancement mode (P> 0.05). The invasion risk of GIST group was significantly different in tumor size, morphology, growth pattern, There was a significant difference between the two groups (P <0.05) in intensifying mode, strengthening intensity, mesenteric fat infiltration, lymph node enlargement, calcification, surrounding invasion and metastasis. [Conclusion] GIST has characteristic features of CT imaging and clinical features. The CT findings of tumor are correlated with biological evaluation. To master the characteristics of GIST is of great significance for the diagnosis, treatment and prognosis evaluation.