CAJ | 학술논문

目的探讨腔外型胃肠道间质瘤的MSCT表现及诊断价值。方法回顾性分析经手术和病理证实的腔外型胃肠道间质瘤患者50例，术前均行螺旋CT平扫加两期或三期增强扫描。结果本组50例GIST中，肿块均向腔外生长，发生于胃15例；发生于小肠15例，其中十二指肠6例，空肠6例，回肠3例；发生于乙状结肠3例，直肠3例；大网膜3例，肠系膜3例，腹膜后5例，盆腔4例，膀胱2例。完全实性12例，实性并坏死30例，实性并出血24例，同时合并出血、坏死或囊变者18例，实性并钙化者3例，积气6例，CT表现40例边界清晰,缘分叶19例，转移3例，其中淋巴结转移4例，复发3例；增强扫描，肿瘤轻度到明显强化，动脉期强化明显者，静脉期及延时期可见持续强；MSCT定位准确率94%(47/50)，良恶性诊断准确率82%(41/50)。结论 MSCT多期扫描结合三维重建技术能准确显示腔外型胃肠道间质瘤的部位、形态、大小、密度及血供关系，对其良恶性判断具有一定临床价值。
목적탐토강외형위장도간질류적MSCT표현급진단개치。방법회고성분석경수술화병리증실적강외형위장도간질류환자50례，술전균행라선CT평소가량기혹삼기증강소묘。결과본조50례GIST중，종괴균향강외생장，발생우위15례；발생우소장15례，기중십이지장6례，공장6례，회장3례；발생우을상결장3례，직장3례；대망막3례，장계막3례，복막후5례，분강4례，방광2례。완전실성12례，실성병배사30례，실성병출혈24례，동시합병출혈、배사혹낭변자18례，실성병개화자3례，적기6례，CT표현40례변계청석,연분협19례，전이3례，기중림파결전이4례，복발3례；증강소묘，종류경도도명현강화，동맥기강화명현자，정맥기급연시기가견지속강；MSCT정위준학솔94%(47/50)，량악성진단준학솔82%(41/50)。결론 MSCT다기소묘결합삼유중건기술능준학현시강외형위장도간질류적부위、형태、대소、밀도급혈공관계，대기량악성판단구유일정림상개치。
Objective To investigate the imaging findings and diagnostic value of multi-slice spiral CT (MSCT) in the extraluminal gastrointestinal stromal tumor (GIST). Methods MSCT findings combined with three-dimensional (3D) reconstruction images of 50 patients with pathological y and surgical y proved extraluminal GIST were retrospectively analyzed. Al plain, dual-phase or Triple-phase contrast enhanced MSCT were performed preoperatively. Results The 50 cases of GIST, al extraluminal ,15 tumors were found in stomach, 15 in smal intestine (6 in duodenum, 6 in jejunum and 3 in ileum), 3 in sigmoid colon, 3 in rectum, 3 in omentum majus, 3 in mesentery, 5 in retroperitoneal, 4 in pelvic and 2 in bladder. 12 tumors were solid homogeneity mass. 38 were heterogeneous-solid tumors. 30 tumors were solid and necrosis. 24 were solid mass with hemor hage. 18 were complicated with hemor hage, necrosis or cystic degeneration. 3 were solid mass with calcification and 6 were pneumatosis. CT showed 40 cases with clear boundary, 19 cases of fate leaf and 3 cases of metastsis (including 4 cases of lymph node metastasis and 3 cases of recur ence). Tumor were mild to intense enhancement on contrast enhanced scan. Al lesions show marked enhancement at arterial phase were durative enhancement in venous and delayed phase.The accuracy for location and quality of MSCT were 94% (47/50) and 82%(41/50). Conclusion Multi-phase enhancement scan of MSCT and 3D-image reconstruction techniques have great value in diagnosing extraluminal gastrointestinal stromal tumors which can show the situation, shape, size, density and artery of the tumor clearly.