摘要
目的 探讨胃肠道间质瘤的CT和超声内镜诊断价值。方法 搜集经手术和病理证实的胃肠道间质瘤患者 11例进行回顾性分析。 11例均行螺旋CT平扫 ,10例行双期增强扫描 ,8例行超声内镜检查。结果 肿瘤位于胃部 8例 ,食管、十二指肠和直肠各 1例。本组良性者 ,肿瘤直径≤5cm ,边界清楚 ,密度均匀 ,可见单个坏死灶。恶性者 ,有如下特征 :(1)肿块直径≥ 7cm ;(2 )肿瘤边缘有分叶 ;(3)瘤体内有多个小片状坏死或大块坏死 ;(4)肿瘤的溃疡大而深 ;(5 )瘤旁常伴成簇状或线状排列的小血管 ;(6 )瘤体内有散在分布的细小钙化点 ;(7)周围组织侵犯或远处转移。本组CT定位准确度为 5 4 5 %(6 / 11) ,超声内镜定位准确度为 87 5 %(7/ 8)。病理学检查肿瘤为良性者 3例 ,恶性者7例 ,增生活跃者 1例。CT判定良恶性准确度为 72 7%(8/ 11) ,超声内镜判定良恶性准确度为6 2 5 %(5 / 8)。结论 CT和超声内镜结合有助于胃肠道间质瘤的定位和良恶性的判断 ,对指导临床治疗和估计预后有一定的价值。
Objective To investigate the value of CT and endoscopic ultrasonography (EUS) in the diagnosis of gastrointestinal stromal tumors (GIST). Methods Eleven patients with surgically and pathologically proved GIST were collected and retrospectively analyzed.Plain CT scanning was performed in all 11 cases and enhancement in 10 cases, while additional EUS in 8 cases.Results Of the 11 lesions, 8 were located in stomach, 1 in esophagus, 1 in duodenum, and 1 in rectum, respectively.In benign GIST, the diameter of the tumor was less than 5 cm, with clear margin and homogeneous density.In malignant GIST, the characteristic appearances were as follows: (1) The diameter of the tumor was more than 7 cm; (2) The tumor was lobular in shape; (3) Lesions contained intratumoral small or large patchy necrosis; (4) The tumor had large and deep ulcers; (5) Around the tumor, small vessels arranged in clumps or in line; (6) The tumor contained scattered small calcifications; (7) Invasion of adjacent tissues and metastasis.The positive predictive value of CT for location of GIST was 54.5% (6/11), the positive predictive value of EUS was 87.5% (7/8).By pathology, benign GIST was identified in 3 cases, malignant in 7 cases, and active proliferation in 1 case.The positive predictive value of CT for differentiation of benign and malignant GIST was 72.7% (8/11), the positive predictive value of EUS was 62.5% (5/8).Conclusion CT combined with EUS are helpful in evaluating the gastrointestinal origin of GIST, and in differentiating between benign and malignant GIST, and in instructing clinical treatment and estimating prognosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2004年第2期197-201,共5页
Chinese Journal of Radiology
关键词
CT
超声内镜诊断
胃肠道间质瘤
增强扫描
Gastrointestinal tract, stromal tumor
Tomography, X-ray computed
Endoscopic ultrasonography
