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目的分析胃肠道外间质瘤(EGIST)的CT表现特征,探讨CT对该肿瘤的诊断价值。资料与方法回顾性分析25例经手术或穿刺病理证实EGIST患者的CT表现(病变的部位、大小、形态及边缘、增强特点、邻近脏器受侵、转移等征象),25例均行CT平扫及双期增强扫描,其中8例又行CTA检查。结果 25例EGIST中,高度危险17例,中度危险5例,低度危险3例,其中5例发生远处转移。单发23例,位于肠系膜10例、网膜6例、后腹膜5例、盆腔2例;多发2例,起自后腹膜及肠系膜。肿瘤直径平均13.2 cm。肿块呈分叶状8例,不规则状4例,类圆形或椭圆形13例。其中1例可见钙化,23例病灶内见囊变及坏死。根据肿瘤的强化方式,分两种类型:Ⅰ型,动脉期大致轻度均匀强化,静脉期强化略高于动脉期。Ⅱ型,动脉期为中度不均匀强化,静脉期进行性强化,强化高于动脉期;囊变、坏死无明显强化;其中15例在动脉期病灶实性成分内可见条状强化的血管影;CTA可清晰显示肿瘤供血动脉及引流静脉。结论 EGIST的CT表现有一定的特征性,在术前诊断及术后随访判断其生物学行为方面有一定价值。
Objective To analyze the CT features of gastrointestinal extraintestinal stromal tumors (EGIST) and investigate the diagnostic value of CT in this tumor. Materials and Methods Retrospective analysis of CT findings (location, size, shape, margins, enhancement features, invasion and metastasis of adjacent organs, etc.) in 25 patients with EGIST confirmed by operation or puncture pathology were retrospectively analyzed. Twenty-five patients underwent CT level Sweep and double enhanced scan, 8 patients underwent CTA examination. Results Of the 25 EGISTs, 17 were at high risk, 5 were moderate risk, 3 were low risk and 5 were distant metastasis. 23 cases were single, located in 10 cases of mesenteric, 6 cases of omentum, 5 cases of retroperitoneal, pelvic in 2 cases; 2 cases of multiple, since the retroperitoneal and mesentery. Tumor diameter average 13.2 cm. The tumor was lobulated in 8 cases, 4 cases of irregular, round or oval in 13 cases. One case showed calcification, cystosis and necrosis in 23 cases. According to the strengthening of the tumor, divided into two types: type Ⅰ, the arterial phase is generally slightly more uniform enhancement of the venous phase slightly higher than the arterial phase. Ⅱ type, the arterial phase was moderately heterogeneous enhancement, progressive venous phase, enhanced higher than the arterial phase; cystic degeneration, no significant enhancement of necrosis; of which 15 cases of arterial phase solid component visible in the stripe-enhanced blood vessels ; CTA can clearly show the tumor feeding artery and drainage veins. Conclusion The CT findings of EGIST have certain characteristics, which have some value in preoperative diagnosis and postoperative follow-up to determine their biological behavior.