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目的:探讨胃肠道间质瘤(GIST)的多层螺旋CT征象与恶性分级的相关性。方法:回顾性分析64例胃肠道间质瘤的资料,所有病例均行多层螺旋CT平扫及增强扫描,并经病理免疫组织化学检查证实。结果:间质瘤以胃部多见,占62.50%(40/64),其次为小肠,占18.75%(12/64)。GIST多表现为类圆形实性,边界清楚(47/64),以外生性生长为主(32/64)。密度多不均匀,坏死(47/64)、溃疡(31/64)常见,以不均匀强化、延迟强化为主。肝脏和腹腔为主要转移部位,转移灶坏死常见,也呈延迟强化。11例GIST伴发其他肿瘤。GIST的部位、坏死与溃疡的存在、强化方式及转移灶的有无与恶性分级呈正相关(P<0.05)。结论:胃肠道间质瘤的螺旋CT表现具有一定特征,并且不均匀强化方式,CT图像上坏死与溃疡的检出、转移灶的出现以及发生部位有助于对恶性间质瘤的判定。
Objective: To investigate the correlation between multislice spiral CT findings and malignant grading of gastrointestinal stromal tumors (GISTs). Methods: The data of 64 cases of gastrointestinal stromal tumors were retrospectively analyzed. All patients underwent multi-slice spiral CT scan and enhanced scan and confirmed by pathological immunohistochemistry. Results: The stromal tumors were more common in the stomach, accounting for 62.50% (40/64), followed by the small intestine, accounting for 18.75% (12/64). GIST mostly showed round-like solidity with clear boundaries (47/64) and mainly extrinsic growth (32/64). Heterogeneous density, necrosis (47/64), ulcers (31/64) common to uneven enhancement, delay-based. Liver and abdominal cavity as the main metastatic site, common metastatic lesions, also showed delayed enhancement. 11 cases of GIST with other tumors. The location of GIST, the presence of necrosis and ulcer, the mode of enhancement and the presence or absence of metastasis were positively correlated with malignant grade (P <0.05). Conclusion: The spiral CT findings of gastrointestinal stromal tumors have certain characteristics, and the heterogeneous enhancement method, the detection of necrosis and ulcer on CT images, the occurrence of metastases and the location of the lesions contribute to the determination of malignant stromal tumors.