利用CT和钡餐造影检查诊断外生型胃肠道间质瘤

The use of CT and barium meal examination in diagnosis exogenous type gastrointestinal stromal tumors

目的研究CT和钡餐造影检查诊断外生型胃肠道间质瘤的优缺点以及它们在外生型胃肠间质瘤中的诊断价值。方法回顾性分析经手术病理证实的20例外生型胃肠道间质瘤影像表现。所有患者均行口服阳性对比剂常规CT增强加三维重建;以及全消化道钡餐造影检查。用卡方检验分析两者在定位、定性诊断准确率的差异。结果 20例研究对象中,CT定位诊断正确13例(65%),定性诊断正确18例(90%)。消化道钡餐定位诊断20例,正确率100%;定性诊断正确12例(60%)。两者在定位、定性诊断的正确率上差异值分别为P<0.01、P=0.0381,均存在统计学差异。两者结合诊断的准确率为95%(19/20)。结论外生型胃肠道间质瘤CT特征明显,定性诊断准确率高,而定位准确率低。钡餐造影明确间质瘤与肠管关系;定位诊断优势明显。CT结合全消化道钡餐造影,能明显提高外生型胃肠道间质瘤的诊断准确率。

Objective To investigate findings of CT and barium meal of exogenous type stromal tumor, and their advan rages and disadvantages in the diagnostic and to analysed diagnostic value. Methods Image findings in 20 patients of exog enous type stromal tumor with histologically confirmed were retrospectively analyzed. Inspection methods included CT scan plus three-dimensional reconstruction and barium meal. With chi square test, the differences of both the positioning and qualitative diagnosis accuracy were compared. Results In all the 20 cases, 13 cases （65%） can be correctly orientated by CT, and for etiologic diagnosis, 18 cases （900/00） were correct. Correspondingly,barium meal can correctly orientate 20 cases （100 % ）, Etiologic diagnosis in 12 cases were correct （60 % ）. Both in the positioning and qualitative diagnosis, accu- racy difference value were P 〈0.01, P = 0. 0381. There were significant differences. The diagnosis accuracy with both was 95%（19/20）. Conclusion The feature of exogenous type stromal tumor is obvious,qualitative diagnosis rate is high, but location accuracy is low. Barium meal can make sure the relationship stromal tumor and bowel. It is good at positio- ning diagnosis. CT scan combined with barium meal can improve diagnostic accuracy for exogenous type stromal tumor.