高度危险胃肠道间质瘤的CT影像学特征研究

Study on CT imaging characteristics of high risk gastrointestinal stromal tumor

目的探讨高度危险胃肠道间质瘤(GIST)的CT影像学特征。方法回顾性分析我院收治的35例GIST患者的临床资料,并依据GIST危险度分级将35例患者分为低-中度危险组(24例)和高度危险组(11例)。比较并分析两组患者的CT影像学特点。结果高度危险组胃部发病、肿瘤直径>10 cm、边界不清晰、平扫密度不均匀、与肠道相通、肿瘤内有血管显示患者占比显著高于低-中度危险组(P<0.05)。高度危险组CT评分显著高于中低危组(P<0.05)。ROC曲线下面积0.763,P=0.014,最佳阀值为2.950分,灵敏度为90.9%,特异度为91.7%。结论发病部位、肿瘤直径、边界清晰程度、平扫密度均匀程度、与肠道间的关系、肿瘤内血管显示情况能够为GIST危险程度判断提供帮助,对患者的治疗具有重要意义。

Objective To investigate the CT imaging characteristics of high risk gastrointestinal stromal tumor(GIST).Methods The clinical data of 35 patients with GIST admitted in our hospital were retrospectively analyzed. According to the risk classification of GIST, 35 patients were divided into low to moderate risk group(24 cases) and high risk group(11 cases). CT imaging features of the two groups were compared and analyzed. Results The proportions of patients of gastric disease, tumor diameter >10 cm, unclear boundary, uneven density of plain scan, intestinal connection and the presence of intratumoral vessels in the high risk group were significantly higher than those in the low to moderate risk group(P<0.05).The CT score of the high risk group was significantly higher than that of low to moderate risk group(P<0.05). The area under ROC curve was 0.763, P=0.014, the optimal threshold was 2.950, the sensitivity was 90.9%, and the specificity was91.7%. Conclusion The disease location, tumor diameter, clear boundary, uniformity of scanning density, relationship with the intestinal tract and the disply of intratumoral vessels can provide help for the determination of the risk degree of GIST,which is of great significance for the treatment of patients.