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目的:探讨CT、MRI和DSA对胃肠道间质瘤(GIST)的诊断价值。方法:对经病理证实的19例GIST的影像学表现进行回顾性分析。其中17例行CT检查(1例同时行MRI,另1例合并肝转移瘤者同时行DSA),2例行DSA检查。结果:19例中肿瘤发生于胃6例,小肠10例,直肠2例,小肠系膜1例;恶性17例,潜在恶性2例;最大径小于5 cm者 4例。CT表现(17例):肿瘤向腔外生长12例,呈分叶状14例,肿瘤内有多发低密度区12例,肿瘤呈中度或明显强化16 例。MRI表现(1例):肿瘤于T1WI呈等、低信号,T2WI呈高信号为主的混杂信号,双期增强扫描示肿瘤静脉期强化较动脉期显著。DSA表现(3例):肿瘤血管丰富,供血动脉增粗,引流静脉提前显影。结论:CT、MRI是GIST的主要影像学检查方法,肿瘤有分叶或多灶性坏死征象可提示恶性或潜在恶性诊断,对于小于5 cm GIST的良恶性判断,该征象可能有更大价值。DSA对GIST的诊断有一定价值。
Objective: To investigate the diagnostic value of CT, MRI and DSA for gastrointestinal stromal tumor (GIST). Methods: Retrospective analysis was performed on the imaging findings of 19 cases of GIST confirmed by pathology. Among them, 17 patients underwent CT examination (1 patient underwent MRI at the same time, another patient with hepatic metastasis had DSA at the same time), and 2 patients underwent DSA examination. Results: Among the 19 cases, tumors occurred in 6 cases of stomach, 10 cases of small intestine, 2 cases of rectum, 1 case of small mesentery, 17 cases of malignant, 2 cases of potentially malignant, 4 cases of maximum diameter less than 5 cm. CT findings (17 cases): Tumor growth outside the chamber in 12 cases, was lobulated in 14 cases, there were multiple low-density areas within the tumor in 12 cases, the tumor was moderate or significantly enhanced in 16 cases. MRI findings (1 case): The tumor showed iso-intensity and hypo-intensity on T1WI, and T2WI showed mixed signal with high signal intensity. The double-phase enhanced scan showed that the enhancement of venous phase was more significant than that of arterial phase. DSA manifestations (3 cases): Tumor vessels are abundant, blood supply arteries are thickened, drainage veins are developed ahead of time. Conclusions: CT and MRI are the main imaging examination methods of GIST. The presence of leafy or multifocal necrotic features in the tumor may indicate a malignant or potentially malignant diagnosis. This sign may be of greater value for the judgment of benign and malignant lesions less than 5 cm in GIST. DSA has some value in the diagnosis of GIST.