影像学检查在胃肠道间质瘤诊治中的应用价值及其进展

Diagnosis of extra-gastrointestinal stromal tumors by MSCT and MRI

AIM: To explore the diagnostic value of multislice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) in extra-gastrointestinal stromal tumors (EGISTs).

METHODS: Twenty-two patients with EGISTs proved by immunohistochemistry were included in this study, of them 16 received MSCT examination and 6 underwent MRI.

RESULTS: According to immunohistochemistry results, there were 5 cases of mid-risk tumors and 17 cases of high-risk tumors. The locations of the tumors included the mesentery (6 cases), omentum (5 cases), pelvic cavity (5 cases), abdominal cavity (3 cases), retroperitoneum (2 cases), and abdominal wall (1 case). The sizes of the tumors ranged from 5.7 to 19.5 cm. The shape of the tumors was lobulated (4 cases), irregular (7 cases), round or oval (11 cases). Four cases appeared as homogenous density and 12 as heterogenous density on CT scans. Two cases demonstrated homogeneous and 14 tumors showed heterogeneous enhancement on enhanced MSCT scans. Of 6 patients who underwent MRI, the tumor appeared as slightly hypointensity in 4 cases and slightly hypo-hyperintensity in 2 cases on T1 weighted images; as iso-hyperintensity in 6 cases on T2 weighted images. The solid part of the tumor appeared as hyperintensity in 6 cases on DWI. Enhanced blood vessels in the solid component of the tumor could be seen in 13 cases on arterial phase. Nine cases (9/22) had distant metastases, including liver metastases (5 cases).

CONCLUSION: EGISTs show some MSCT and MRI characteristics. MSCT and MRI are effective methods for the diagnosis of EGISTs, and MRI has the advantage of early detection of mesenteric, retinal, peritoneal and bone metastases.