Abstract
目的 探讨胃肠道间质瘤的CT和超声内镜诊断价值.方法搜集经手术和病理证实的胃肠道间质瘤患者11例进行回顾性分析.11例均行螺旋CT平扫,10例行双期增强扫描,8例行超声内镜检查.结果肿瘤位于胃部8例,食管、十二指肠和直肠各1例.本组良性者,肿瘤直径≤5 cm,边界清楚,密度均匀,可见单个坏死灶.恶性者,有如下特征:(1)肿块直径≥7 cm;(2)肿瘤边缘有分叶;(3)瘤体内有多个小片状坏死或大块坏死;(4)肿瘤的溃疡大而深;(5)瘤旁常伴成簇状或线状排列的小血管;(6)瘤体内有散在分布的细小钙化点;(7)周围组织侵犯或远处转移.本组CT定位准确度为54.5%(6/11),超声内镜定位准确度为87.5%(7/8).病理学检查肿瘤为良性者3例,恶性者7例,增生活跃者1例.CT判定良恶性准确度为72.7%(8/11),超声内镜判定良恶性准确度为62.5%(5/8).结论 CT和超声内镜结合有助于胃肠道间质瘤的定位和良恶性的判断,对指导临床治疗和估计预后有一定的价值。
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