MSCT三期增强扫描对胃淋巴瘤、胃间质瘤与进展期胃癌的鉴别诊断

Differential Diagnosis of Gastric Lymphoma, Gastric Stromal Tumor and Advanced Gastric Cancer by MSCT Three-phase Enhanced Scan

目的探讨MSCT三期增强扫描对胃淋巴瘤、胃间质瘤与进展期胃癌鉴别诊断的价值。方法回顾性分析我院2013年1月-2017年9月期间收治经病理证实的32例胃淋巴瘤、32例胃间质瘤、40例进展性胃癌的临床病例资料。结果胃癌粘膜面受累(100%)明显高于胃淋巴瘤(12.50%)、胃间质瘤(18.75%)(P<0.05),胃壁厚度>2cm(45.00%)明显低于胃淋巴瘤(87.50%)、胃间质瘤(93.75%)(P<0.05);胃淋巴瘤胃壁侵犯范围>50%(62.50%)明显高于胃间质瘤(12.50%)、胃癌(30.00%)(P<0.05);胃淋巴瘤动脉期、门脉期、延迟期CT值和强化值明显低于胃间质瘤、胃癌(P<0.05);胃间质瘤动脉期CT值和强化值明显低于胃癌(P<0.05)、门脉期CT值明显高于胃癌(P<0.05);胃淋巴瘤明显强化率(0.00%)明显低于胃癌(65.00%)、胃间质瘤(68.75%)(P<0.05);3种胃部肿瘤周围淋巴结肿大阳性率依次为胃淋巴瘤(87.50%)、胃癌(65.00%)、胃间质瘤(6.25%),组间比较差异均具有统计学意义(P<0.05)。结论MSCT三期增强扫描对胃淋巴瘤、胃间质瘤与进展期胃癌的鉴别诊断方面具有一定的临床价值。

Objective To explore the value of MSCT three-phase enhanced scan in the differential diagnosis of gastric lymphoma,gastric stromal tumor and advanced gastric cancer.Methods The clinical case data of 32 cases of gastric lymphoma,32 cases of gastric stromal tumor and 40 cases of progressive gastric cancer confirmed by pathology from January 2013 to September 2017 were retrospectively analyzed.Results Mucosal surface involvement of gastric cancer was significantly higher than that of gastric lymphoma and gastric stromal tumor (100% vs 12.50% vs 18.75%),and the gastric wall thickness (or tumor diameter)>2cm was significantly lower than that of gastric lymphoma and gastric stromal tumors (45.00% vs 87.50% vs 93.75%)(P<0.05).The gastric wall invasion range>50% of gastric lymphoma was significantly greater than that of gastric stromal tumor and gastric cancer (62.50% vs 12.50% vs 30.00%)(P<0.05).The CT values and enhancement values in arterial phase,portal phase and delayed phase of gastric lymphoma were significantly lower than those of gastric stromal tumor and gastric cancer (P<0.05).The CT value and enhancement value in arterial phase of gastric stromal tumor were significantly lower than those of gastric cancer (P<0.05),and the CT value in portal phase was significantly higher than that of gastric cancer (P<0.05).The apparent enhancement rate of gastric lymphoma was significantly less than that of gastric cancer and gastric stromal tumor (0.00% vs 65.00% vs 68.75%)(P<0.05).The positive rates of peripheral lymph node enlargement of gastric lymphoma,gastric cancer and gastric stromal tumor were 87.50%,65.00% and 6.25%)(P <0.05).Conclusion MSCT three-phase enhanced scan has certain clinical value in the differential diagnosis of gastric lymphoma,gastric stromal tumor and advanced gastric cancer.