目的探讨128层螺旋CT三期增强 扫描在胃间质瘤诊断中的应用价值。方法 选取我院2014年1月到2017年1月收治的胃 间质瘤患者31例，收集其临床、影像学资 料等，分析31例胃间质瘤患者128层螺旋 CT平扫及三期增强扫描图像表现，并以病 理学检查结果为标准，比较128层螺旋CT 平扫与CT三期增强扫描对胃间质瘤的检 出率及诊断准确率。结果 128层螺旋CT平 扫对胃间质瘤的检出率及准确诊断率分别 为83.87%、77.41%，三期增强对胃间质瘤 的检出率及准确诊断率分别为100.00%、 96.77%，三期增强对胃间质瘤的检出率及 准确诊断率明显优于CT平扫，差异具有统 计学意义(P<0.05)；128层螺旋CT平扫中 17例胃间质瘤外观形态多表现为圆型或类 圆形，边界清楚，与周围组织分界清晰， 未见明确的粘连和侵犯征象，腹膜后淋 巴结未见肿大。14例患者表现为不规则 形，向腔内或腔外生长，其中1例患者可 见点状钙化灶；128层螺旋CT三期增强扫 描中，增强后明显均匀强化者6例，内部 呈点状不均匀强化者4例；强化方式呈渐 进性强化，动脉期及静脉期肿瘤实质部分 呈中度至重度明显强化，且静脉期肿瘤实 质部分强化程度明显超过动脉期，至延迟 期仍然持续明显强化；3例患者胃腔内气 体进入病灶出现气体影，未见钙化。结论 128层螺旋CT三期增强扫描可有效显示胃 间质瘤的图像特征，对胃间质瘤检出及诊 断准确率高。

Objective To investigate the value of spiral CT three phase enhanced scan in the diagnosis of gastric stromal tumors. Methods A total of 31 patients with gastric stromal tumors treated in our hospital from January 2014 to December 2017 were selected, the clinical data and imaging data were collected, analysis of 31 cases of patients with gastric cancer CT scan and three phase enhanced CT scanning images, and the pathological examination results as the standard, compared with the detection rate, the accuracy rate between the CT plain scan and three phase enhanced. Results CT scan detection rate of gastric stromal tumors and the accurate diagnosis rate were 83.87%, 77.41%, the detection rate and the accurate diagnostic rate of three phase enhance CT were 100%, 96.77%, higher than that of CT scan. The difference was statistically significant (P<0.05). CT scan in 17 cases of gastric stromal tumor morphology showed round or oval, clear edge, clear boundaries with the surrounding tissue adhesion and invasion, no clear signs, no enlarged retroperitoneal lymph nodes. 14 patients showed irregular shape, growth into or out of the lumen, including 1 cases of patients with punctate calcification; three phase enhanced CT scan showed homogeneous enhancement in 6 cases, 4 cases of internal punctate uneven enhancement, progressive enhancement in arterial phase showed uneven enhancement and venous phase enhancement than arterial phase, to delay obviously continue to strengthen; 3 cases of patients with gastric cavity gas into the lesion gas shadow, no calcification. Conclusion Three phase enhanced CT scan can effectively display the image features of gastric stromal tumors, and it has high accuracy in the diagnosis of gastric stromal tumors.