目的 观察多层螺旋CT在胃肠道 间质瘤(GIST)术前诊断的临床价值。方法 采用TOSHIBA Aquilion 16排螺旋CT对我 院64例GIST患者进行检测，分别进行CT平 扫及三期增强扫描，结果输入ADW4.2工作 站重建，由我院2名资历较深的影像科医 师进行阅片，分析64例患者多层螺旋CT扫 描结果。结果 64例GIST患者胃41例、小 肠15例、直肠3例、食管3例、网膜2例。 形态：类圆形或椭圆形51例、不规则分叶 状13例。分布：胃肠道腔外42例、胃肠 道腔内15例、胃肠道腔内外7例。黏膜状 态：黏膜光滑41例、黏膜有明显溃疡23 例。囊实性49例、实性15例。密度：平扫 及肝实质比较均匀密度基本一致29例，周 边等密度内部较低31例，4例瘤内有气体 影，均无钙化。增强扫描可见肿瘤均匀强 化33例，不均匀强化31例。均匀强化患者 31例良性，2例潜在恶性，不均匀强化1例 良性，11例潜在恶性，19例患者恶性。结 论 多层螺旋CT诊断胃肠道间质瘤可准确 鉴别肿瘤良、恶性，可为术前病理判断及 手术选择提供客观依据。

Objective To observe the clinical value of multi-slice spiral CT in preoperative diagnosis of gastrointestinal stromal tumor (GIST). Methods 64 patients with GIST in our hospital were detected by TOSHIBA Aquilion 16 slice spiral CT. CT plain scan and three phase enhanced scan were performed. The results were input to ADW4.2 workstation for reconstruction. The images were analysised by 2 senior doctors of the imaging department in our hospital. The results of multi-slice spiral CT scan of the 64 patients were analyzed. Results Among 64 patients with GIST, there were 41 cases of stomach, 15 cases of small intestine, 3 cases of rectum, 3 cases of esophagus and 2 cases of omentum. Shape: quasicircular or oval in 51 cases, irregular lobulated in 13 cases. Distribution: 42 cases in external gastrointestinal tract, 15 cases in internal gastrointestinal tract and 7 cases in internal and external gastrointestinal tract. Mucosal status: smooth mucosa in 41 cases, mucosa with obvious ulcer in 23 cases, cystic solid in 49 cases and solid in 15 cases. Density: compared plain scan and liver parenchyma, the homogeneous density was basically in accordance in 29 cases, equal dencity around and lower inside in 31 cases, gaseous density in 4 cases, without calcification. Enhanced CT scan showed tumors with homogeneous enhancement in 33 cases and inhomogeneous enhancement in 31 cases. In patients with homogeneous enhancement, 31 cases were benign and 2 cases were potentially malignant. In patients with inhomogeneous enhancement, 1 cases were benign, 11 cases were potentially malignant and 19 cases were malignant. Conclusion Multi slice spiral CT in the diagnosis of gastrointestinal stromal tumor can accurately identify the benign and malignant tumors, which can provide objective basis for the preoperative pathological diagnosis and choice of surgery.