CAJ | 학술논문

目的：探讨多排螺旋CT对胃肠道间质瘤的诊断价值。方法回顾性分析经手术、免疫组化证实的23例胃肠道间质瘤CT平扫和增强表现，并与病理学对照。结果肿瘤多单发。2例发生在食道、9例发生在胃、1例位于十二指肠、3例位于小肠、1例位于结肠、7例位于胃肠道外。CT平扫表现为腔内、外或略低密度软组织肿块。6例为良性，瘤体直径＜3 cm ,呈圆形或类圆形、边缘光滑、密度均匀、增强后均匀强化，CT值增加10~35 HU；5例为低度恶性，瘤体直径2.5~6 cm，呈圆形或类圆形、边缘光滑、密度多均匀、中等强化，增强后CT值增加25~55 HU；12例为恶性，瘤体较大为4.5~20 cm，呈分叶状、内见囊变坏死及钙化、增强后病灶明显强化、密度明显不均匀，CT值增加45~80 HU，可见转移灶。对CT征象（肿块位置、大小、形状、密度、强化程度）与病灶良、恶性的关系进行统计学分析，χ2值分别为8.74、17.66、22.77、18.5、26.45，P<0.05，均有统计学差异。结论多排螺旋CT可以清楚地显示肿块数量、位置、大小、形态、边缘、内部密度及强化特点，显著提高对胃肠道间质瘤的检出率和诊断准确性，对临床手术及治疗有重要指导意义。
목적：탐토다배라선CT대위장도간질류적진단개치。방법회고성분석경수술、면역조화증실적23례위장도간질류CT평소화증강표현，병여병이학대조。결과종류다단발。2례발생재식도、9례발생재위、1례위우십이지장、3례위우소장、1례위우결장、7례위우위장도외。CT평소표현위강내、외혹략저밀도연조직종괴。6례위량성，류체직경＜3 cm ,정원형혹류원형、변연광활、밀도균균、증강후균균강화，CT치증가10~35 HU；5례위저도악성，류체직경2.5~6 cm，정원형혹류원형、변연광활、밀도다균균、중등강화，증강후CT치증가25~55 HU；12례위악성，류체교대위4.5~20 cm，정분협상、내견낭변배사급개화、증강후병조명현강화、밀도명현불균균，CT치증가45~80 HU，가견전이조。대CT정상（종괴위치、대소、형상、밀도、강화정도）여병조량、악성적관계진행통계학분석，χ2치분별위8.74、17.66、22.77、18.5、26.45，P<0.05，균유통계학차이。결론다배라선CT가이청초지현시종괴수량、위치、대소、형태、변연、내부밀도급강화특점，현저제고대위장도간질류적검출솔화진단준학성，대림상수술급치료유중요지도의의。
Objective To investigate the effects of MSSCT (Multi-slice Spiral Computerized Tomography) in diagnosing GISTs (Gastrointestinal Stromal Tumors). Methods Both non-contrast-enhanced and enhanced CT scanning results of 23 GIST patients who were confirmed through surgical operations and immunohistochemistry were retrospectively analyzed. Pathological manifestations of GISTs were taken as the control group for comparison with CT scanning results. Results Among all the cases, most were found solitary;2 occurred in the esophagus;9 in the stomach;1 in the duodenum;3 in the small intestine;1 in the colon;7 outside the gastrointestinal tract. Non-contrast-enhanced CT scanning displayed the features of GISTs as slightly-low-density or equal-density soft tissues inside and outside the cavity. With deployment of enhanced CT scanning, there were 6 cases identiifed to be benign with the characteristics involving the diameter of tumors<3 cm, round or round-like shapes, smooth edges, even density and uniform enhancement (CT value was increased by 10 to 35 HU);slightly malignant tumors were revealed in 5 patients as diameter<2.5 to 6cm, round or round-like shapes, smooth edges, averagely uniform density and moderate enhancement (The increment in the value of CT was 25 to 55HU);12 cases showed the signs of relatively large tumors (Diameter<4.5 to 20 cm), lobulated shapes, visible interior cystic necroses and calciifcation, obviously uneven density as well as visible metastases and apparent enhancement (The increase of 45 to 80 HU could be obtained in the CT value) and were identified to be malignant. Through statistical analysis of the correlation between the CT features (including locations, sizes, shapes, density and enhanced features) and the nature of tumors (benignancy or malignancy), the χ2 values were 8.74, 17.66, 22.77, 18.5 and 26.45 respectively with statistical differences (P<0.05). Conclusion MSSCT presented its great capability for clear demonstrations of tumors in the aspects of their numbers, locations, sizes, shapes, edge, density and enhanced features, which contributed to a remarkable improvement in detection and accurate diagnosis of GISTs and was of fundamental signiifcance in relevant clinical surgeries and treatment.