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目的探讨高危险程度胃肠道间质瘤(HRGIST)的CT表现特征。方法回顾性分析2009年8月-2014年3月24例经手术病理证实的HRGIST的CT表现,并讨论其CT特征。结果肿瘤位于胃部12例,小肠11例(十二指肠/空肠/回肠=5/4/2),直肠1例;肿块最大径2.5~15.0 cm,最大径>5 cm者22例,<5 cm者2例;24例中20例肿块形态不规则,21例周围脂肪间隙模糊;24例肿块均可见不同程度坏死囊变,15例溃疡形成,2例瘤体破溃穿孔,伴腹腔积液、积气,3例可见钙化。增强扫描大部分呈中度至明显不均匀强化,其中小肠HRGIST较胃HRGIST强化更明显,并可见丰富的血管供应;3例伴发肝脏多发转移。结论 HRGIST的CT表现有一定特征性,熟悉其影像学表现有助于对该病的诊断。
Objective To investigate the CT features of high risk gastrointestinal stromal tumors (HRGIST). Methods The CT findings of 24 patients with pathologically confirmed HRGIST from August 2009 to March 2014 were retrospectively analyzed. Their CT features were discussed. Results Tumors were located in 12 cases of stomach, 11 cases of small intestine (duodenum / jejunum / ileum = 5/4/2), 1 case of rectum, 22 cases of maximal diameter of 2.5-15.0 cm, 5 cm in 2 cases; 24 cases, 20 cases of irregular shape of the lumps, 21 cases of obesity around the fat space; 24 cases were seen varying degrees of necrotic cystic degeneration, 15 cases of ulcer formation, 2 tumor rupture perforation, Liquid, gas, visible calcification in 3 cases. Most of the enhancement scan showed moderate to obvious uneven enhancement. The HRGIST in the small intestine was more obvious than that of the gastric HRGIST, and the abundant vascular supply was found. Three cases had multiple liver metastases. Conclusion The CT findings of HRGIST have certain characteristics. Familiar with the imaging findings of HRGIST can help to diagnose the disease.