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目的分析胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的螺旋CT(multi-detector row spiralcomputeel Tomography,MSCT)表现,评价其对该病的诊断价值。方法回顾性分析2000年3月—2010年10月经手术病理证实的32例GIST的MSCT表现,并将其与病理的生物学危险性进行对比研究。结果病理高、中、低及极低危险性GIST依次为15、6、7、4例。GIST主要CT表现,肿块腔外生长为主,大部分病灶边界清楚,呈类圆形或分叶状,密度均匀或不均匀,3例可见钙化,GIST增强静脉期强化较动脉期更明显,局部均无淋巴结转移,转移到肝脏的4例,同时伴前腹壁转移1例。15例肿块长径≥5cm,密度多不均匀,可有囊变、坏死、出血等,增强不均匀强化,其中11例病理为高风险性;17例肿块长径<5cm的病灶中,大多中度均匀强化,其中13例为中度及以下危险性。结论 GIST患者的MSCT表现具有一定的特征性,MSCT对准确定位、术前估计肿瘤的风险级别、术后随访有重要价值。
Objective To analyze the performance of multi-detector row spiral computed tomography (MSCT) in gastrointestinal stromal tumors (GIST) and evaluate its diagnostic value. Methods The MSCT findings of 32 cases of GIST confirmed by surgery and pathology from March 2000 to October 2010 were retrospectively analyzed and compared with the biological risk of pathology. Results High, moderate, low and very low risk GIST were 15,6,7,4 cases. GIST main CT manifestations of lumps mainly lumpectomy, most of the lesions clear boundary, round or lobulated, uniform or uneven density, calcified in 3 cases, enhanced GIST venous phase more obvious than the arterial phase, local No lymph node metastasis, the transfer to the liver in 4 cases, accompanied by an anterior abdominal wall metastasis in 1 case. In 15 cases, the longest diameter of the lumps was more than or equal to 5 cm, and the density was not uniform. There were cystic degeneration, necrosis and hemorrhage, which enhanced the heterogeneity. Eleven of them were high risk. Among the 17 lumens <5 cm in diameter, Degree of uniform enhancement, including 13 cases of moderate and below the risk. Conclusions The MSCT findings of GIST patients have certain characteristics. The accuracy of MSCT in determining the location of the tumor, the preoperative evaluation of the tumor risk level, and postoperative follow-up have important value.