论文部分内容阅读
目的对不同分级胃肠道间质瘤(GIST)的计算机断层扫描(CT)征象进行对比分析,评价CT表现对GIST病理分级的作用。方法收集有完整CT及病理组织学资料的原发性GIST共58例,其中恶性41例,良性和交界性者17例,对照病理组织学与病理分级,分析其CT征象对GIST分级的作用。结果发生于小肠、直肠的GIST比来源于胃和食道的恶性可能性更大。50例GIST表现为向腔外及壁间生长,其中38例为恶性;肿瘤平均最大径为7.5 cm,最大径≥7.5 cm者共26例,其中恶性23例;呈分叶状生长的GIST 35例,其中恶性30例。所有良性或交界性的GIST边界清晰,19例恶性GIST边界不清或部分不清。所有的恶性GIST均呈不均匀强化,均见坏死,10例良性或交界性者不均匀强化,亦可见坏死。15例恶性GIST出现周围侵犯。5例肝转移,1例腹膜种植转移。肿瘤明显强化、肿瘤表面血管、瘤内粗大血管、肿瘤腔侧面黏膜强化环及肿瘤腔侧面出现溃疡这几个因素在两组之间差异均无统计学意义。结论 CT检查对GIST的术前诊断和病理分级的评估有重要的意义。
Objective To compare the computed tomography (CT) features of different graded gastrointestinal stromal tumors (GISTs) and evaluate the role of CT in the pathological grading of GIST. Methods Fifty-eight primary GISTs with complete CT and histopathological data were collected. Among them, 41 were malignant, 17 were benign and borderline. The histopathological and histopathological grading was used to analyze the effect of CT signs on GIST grading. As a result, GIST in the small intestine and rectum is more likely to be malignant than in the stomach and esophagus. 50 cases of GIST showed growth to the outside of the cavity and the wall, of which 38 cases were malignant; the average diameter of the tumor was 7.5 cm, the maximum diameter was ≥ 7.5 cm, a total of 26 cases, of which malignant 23 cases; lobulated growth of GIST 35 Cases, of which 30 cases of malignancy. All benign or borderline GIST boundaries were clear, and 19 cases of malignant GIST border were unclear or partially unclear. All of the malignant GIST showed uneven enhancement, were seen necrosis, 10 cases of benign or borderline uneven enhancement, also visible necrosis. 15 cases of malignant GIST around the violation. 5 cases of liver metastases, 1 case of peritoneal metastasis. Significant enhancement of the tumor, tumor surface blood vessels, tumor thick blood vessels, tumor cavity side mucosal enhanced ring and ulceration of the tumor cavity side of these several factors in the two groups were no significant difference. Conclusion CT examination of GIST preoperative diagnosis and assessment of pathological grade is of great significance.