摘要
目的分析胃肠间质瘤(GIST)的多层螺旋CT表现和临床病理特点,及其关系,评价MSCT的诊断价值。方法回顾性分析36例经病理证实的胃肠间质瘤的螺旋CT表现和病理学资料,将CT表现与生物学危险性进行对比研究。结果①36例GIST发生于胃24例,小肠7例,大肠4例,肠系膜1例。高度危险7例,中度危险12例,低度危险11例,极低危险6例。②肿瘤多呈网形、类圆形或不规则形,部分与局部管壁分界不清。12例向腔内生长,24例腔外或同时向腔内外生长;平扫肿瘤密度均匀或不均匀,增强后呈均匀或不均匀轻中度或明显强化。③15例肿瘤最长径≥50 mm,21例肿瘤最长径<50mm,肿块形状规则19例,不规则17例,肿瘤大小及形态与肿瘤危险程度间差别有统计学意义(P<0.01);31例边界清楚,15例边界不清,肿瘤边缘情况与肿瘤危险程度间差别有统计意义(P<0.01);生长方式与肿瘤危险程度间差别无统计学意义(P>0.01);密度均匀15例,不均匀21例,增强均匀强化14例,不均匀为22例,肿瘤密度和强化方式与肿瘤危险程度间差别有统计学意义(P<0.01)。肿瘤最长径≥50 mm、形状不规则、边界不清、密度不均匀、呈不均匀明显强化多为中、高度危险性;最长径<50 mm、形状规则、边界清楚、密度均匀、呈均匀强化的病灶多为中度以下危险性。结论 MSCT CT能准确判断CIST的危险程度,对设计治疗方案及预后评估有重要价值。
Objective To evaluate the correlation between multi-slice spiral CT （MSCT） findings and pathologic features of gastrointestinal stromal tumors （GIST）. Methods The CT features of 36 patients with confirmed GIST were compared with the pathologic findings. Results The tumors were located in the stomach （24）, small intestine （7）, colon （4） or mesentery （1）. The risk of malignancy was high （7）, intermediate （12）, low （11 ） or very low （6 homogeneous or non-heterogeneous tumor density. The tumor was smaller than 5 cm in 21 patients with the rest larger than 5 cm. The tumors were round or lobulated with well-defined （19） or poorly-defined （17） margins, intra-cavitary （7） or extra- eavitary and mixed （24） growth patterns. The size and shape of GIST were significantly different between the benign and malignant tumors （P 〈 0.01 ）. The tumor growth patterns did not differ significantly among the different risk groups （P 〉 0.01 ）. Of the 15 tumors with homogeneous densities, 14 showed homogeneous contrast enhancement. The remaining tumor and 21 tumors of heterogeneous densities on the unenhanced CT showed heterogeneous contrast enhancement. The CT density and contrast enhancement pattern were significantly different among the different risk groups （P 〈 0.01 ）. Conclusion MSCT features of tumor size larger than 5 cm with irregular shape,poorly-defined boundary, heterogeneous CT density and contrast enhancement indicate intermediate to high risk of malignancy in GIST.
出处
《影像诊断与介入放射学》
2012年第1期34-38,共5页
Diagnostic Imaging & Interventional Radiology
