Objective To summarize the imaging findings and identify CT predictors of malignancy of gastrointestinal stromal tumors(GISTs). Methods 58 patients of gastrointestinal stromal tumors proved by pathologically and immunohistochcmically were reviewed. Five patients underwent X-ray examination, 52 cases computed tomography, and five cases the both two examinations. Two experienced radiologists retrospectively reviewed the imaging findings in consensus. Statistical analysis were performed by using v2 testing and Fisher's exact test. Results Among 58 patients, 18 cases were benign, and 40 cases were malignant. Significant statistical differences were existed between benign and malignant lesions in the aspects of size, contour, growth pattern, pattern and degree of enhancement, and metastasis (P<0. 05). For the diagnosis of malignant tumor, the sensitivity of sizc(2&5 cm) , lobulatcd appearance, exophytic and mixed growth patterns, heterogeneous enhancement pattern, moderate or marked enhancement, periphery infiltration and metastasis was 82. 5% , 69. 4% , 94. 4% , 83. 3%, 86.8% , 36. 1% , 25.0% respectively , the specificity was 72. 2% , 93. 8% , 43. 8% , 68. 8% , 78. 6% , 100% , 100% respectively, and the accuracy was 79. 3% , 76. 9% , 78. 8% , 78. 8% , 78. 8% , 55. 8% , 48. 1% respectively. Conclusion GISTs have characteristic imaging findings. CT images can be considered an essential tool for the differential diagnosis of benign and malignant tumor.%目的 总结胃肠道间质瘤(GISTs)的影像学表现,探讨CT征象对侵袭危险诊断的价值.方法 收集经手术病理及免疫组化诊断的GISTs 58例.X线检查11例,CT检查52例,其中5例同时行X线和CT检查.影像征象由2名高级职称医师阅片确认,统计学分析采用χ2检验和Fisher确切概率法.结果 58例病理上良性18例,恶性40例.良恶性间质瘤在病灶大小、边缘轮廓、生长方式、强化方式、强化程度、远处转移等方面差异有统计学意义(P<0.05).肿瘤(≥5 cm)、边缘分叶、混合型或腔外型生长、强化不均匀、中度或明显强化、周围浸润和远处转移对恶性间质瘤诊断的敏感度分别 为82.5%、69.4%、94.4%、83.3%、86.8%、36.1%、25.0%,特异度分别为72.2%、93.8%、43.8%、68.8%、78.6%、100%、100%,准 确度分别为79.3%、76.9%、78.8%、78.8%、78.8%、55.8%、48.1%.结论 GISTs有较明显的影像学表现及特征,CT征象对其良恶性诊断有重要价值.
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