Velasco S, Milin S, Maurel C, Richer J-P, Sylvain C, Hannequin J, Tasu J-P
Service de radiologie, CHU de Poitiers, BP 577, 86000 Poitiers, France. velasco
Gastroenterol Clin Biol. 2008 Dec;32(12):1001-13. doi: 10.1016/j.gcb.2008.07.011. Epub 2008 Nov 7.
To present the scanographic features of gastrointestinal stromal tumor (GIST) and to discuss their differential diagnosis.
A retrospective study of 45 patients who underwent surgery for GIST between January 1990 and March 2006 was performed.
Patient age was 64 years on average. The most common symptoms were abdominal pain and gastrointestinal bleeding. Tumors were located in the stomach in 28 patients (body: 19, antrum: 5, fundus: 4), the small intestine in 13 (jejunum: 6, duodenum: 4, ileum: 3), the rectum in two and the small bowel mesentery in two. Computed tomography showed a large (average size: 9.2 cm, range 3.3-30 cm) exophytic extragastric lobulated mass with an associated wall thickening in 35 cases (78%). The pattern was an endoluminal polyp (average size: 3.2 cm, range 2.2-5.5 cm) in eight cases (18%). The two mesenteric stromal tumors (4%) were seen as well-delimited lobulated large masses (3 and 12 cm). The enhancement was peripheral with central hemorrhagic, necrotic and cystic areas in 37 cases (82%). Mucosal ulceration was seen in 18 cases (40%) and ascites in five (11%). Peritoneal spread and liver metastasis were demonstrated in three patients (7%). Calcification, metastatic lymphadenopthy, venous thrombosis or vascular invasion were not seen.
Scanographic features of GIST can suggest the diagnosis of GIST before surgery.
阐述胃肠道间质瘤（GIST）的影像学特征并探讨其鉴别诊断。
对1990年1月至2006年3月间接受GIST手术的45例患者进行回顾性研究。
患者平均年龄64岁。最常见症状为腹痛和胃肠道出血。肿瘤位于胃的有28例（胃体：19例，胃窦：5例，胃底：4例），位于小肠的有13例（空肠：6例，十二指肠：4例，回肠：3例），位于直肠的2例，位于小肠系膜的2例。计算机断层扫描显示，35例（78%）为大的（平均大小：9.2 cm，范围3.3 - 30 cm）外生性胃外分叶状肿块，伴有相关的壁增厚。8例（18%）表现为腔内息肉（平均大小：3.2 cm，范围2.2 - 5.5 cm）。2例肠系膜间质瘤（4%）表现为边界清晰的分叶状大肿块（3 cm和12 cm）。37例（82%）增强表现为周边强化，中央有出血、坏死和囊性区域。18例（40%）可见黏膜溃疡，5例（11%）可见腹水。3例患者（7%）出现腹膜播散和肝转移。未见钙化、转移性淋巴结肿大、静脉血栓形成或血管侵犯。
GIST的影像学特征可在手术前提示GIST的诊断。
