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目的探讨胃肠道间质瘤(GISTs)的多层螺旋CT表现及其诊断价值。方法收集经手术病理证实的GISTs23例,术前均行多层螺旋CT平扫及双期增强扫描。结果 23例中,肿瘤发生于胃12例,空、回肠7例,十二指肠2例,食管和小肠系膜各1例。良性间质瘤5例,交界性2例,恶性间质瘤16例。良性平均直径3.6cm,交界性平均直径4.4cm,恶性者平均直径6.7cm。病灶呈圆形或类圆形。平扫:呈均匀等密度7例;肿块周边呈等到密度,中央低密度区15例;混杂密度1例。增强:病灶呈明显均匀强化6例;病毒灶不均匀强化,其中可见散在囊状坏死17例。结论多层螺旋CT是目前GISTs检查的最佳选择,并能通过多方位重建(MPR)更清晰显示病灶各项特征,多层CT血管造影三维成像(3D-MSCTA)寻找肿瘤血管及其他血管变化,显著提高了GISTs的检出率和诊断准确率,对GISTs的定位和定性诊断具有重要价值。
Objective To investigate the multi-slice spiral CT findings of gastrointestinal stromal tumors (GISTs) and their diagnostic value. Methods Twenty-three patients with pathologically confirmed GISTs were collected. The patients underwent multi-slice spiral CT scan and double-phase enhanced scan before operation. Results Of the 23 cases, tumors occurred in 12 cases of stomach, 7 cases of empty and ileum, 2 cases of duodenum, 1 case of esophagus and small mesentery. 5 cases of benign stromal tumors, borderline in 2 cases, 16 cases of malignant stromal tumors. The average diameter of benign 3.6cm, the average junction diameter of 4.4cm, the average diameter of malignant 6.7cm. The lesion was round or round. Plain scan: uniform density was 7 cases; mass was waiting until the surrounding density, the central low-density area in 15 cases; mixed density in 1 case. Enhanced: lesions were significantly enhanced in 6 cases; uneven enhancement of the virus, which showed scattered cystic necrosis in 17 cases. Conclusions Multi-slice spiral CT is the best choice for GISTs examination at present, and can be used to identify the features of lesions by multi-orientation reconstruction (MPR) and to find the tumor blood vessels and other vascular changes by multi-slice CT angiography three-dimensional imaging , Which significantly improves the detection rate and diagnostic accuracy of GISTs, which is of great value for the localization and qualitative diagnosis of GISTs.