Ji Jian-song, Zhang Shi-zheng, Lu Chen-ying, Su Jin-liang, Wang Zu-fei, Zhao Zhong-wei, Xu Min, Hu Xiang-hua
Department of Radiology, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou 310016, China.
Zhonghua Yi Xue Za Zhi. 2006 Feb 28;86(8):560-4.
To evaluate the diagnostic value of spiral CT and its reconstruction techniques in the diagnosis of extraluminal type gastric stromal tumors.
The data of spiral CT performed 1 week before operation of 17 extraluminal type cases, 11 males and 6 females, aged 35.5 (13-67), from 33 patients of gastric stromal tumors proved by pathology and immunohistochemistry, were analyzed retrospectively.
The accuracy rates of level diagnosis and qualitative diagnosis of extraluminal type gastric stromal tumor by spiral CT were 88.2% and 82.4% respectively. The main CT manifestations included: (1) extraluminal mass connected with the gastric wall, with round or lobulated margin and characteristic horn-like appearance and direct invasion, more than 5.0 cm in diameter; (2) inhomogeneous density of mass, including mild to moderate uneven enhancement in artery phase and obvious enhancement in vein and delay phase in 15 cases, and obvious enhancement in artery phase and decrease of enhancement in portal vein phases in 2 cases. (3) Irregular niches and sinus in the margins of the intraluminal masses (n = 11) and unclear border of the masses and invasion into nearby structures (n = 9); (4) connection of the tumor and stomach wall by broad boundary or failure to distinguish the tumor and stomach wall; and (5) invasion to the surrounding tissues and organs as a sign of malignant tumors.
Spiral CT and its reconstruction techniques have important value in level diagnosis and qualitative diagnosis of extraluminal type gastric stromal tumors.
评估螺旋CT及其重建技术在腔外型胃间质瘤诊断中的价值。
回顾性分析经病理及免疫组化证实的33例胃间质瘤患者中17例腔外型患者（男11例，女6例，年龄35.5岁（13 - 67岁））术前1周螺旋CT检查资料。
螺旋CT对腔外型胃间质瘤的定位诊断准确率为88.2%，定性诊断准确率为82.4%。主要CT表现为：（1）腔外肿块与胃壁相连，边缘呈圆形或分叶状，有特征性的角状外观及直接侵犯，直径大于5.0 cm；（2）肿块密度不均匀，15例动脉期呈轻至中度不均匀强化，静脉期及延迟期明显强化，2例动脉期明显强化，门静脉期强化程度减低；（3）腔内肿块边缘有不规则龛影及窦道形成（n = 11），肿块边界不清并侵犯邻近结构（n = 9）；（4）肿瘤与胃壁以宽基底相连或肿瘤与胃壁分界不清；（5）肿瘤侵犯周围组织器官提示为恶性肿瘤。
螺旋CT及其重建技术在腔外型胃间质瘤的定位诊断和定性诊断中具有重要价值。
