128层螺旋CT检查及多平面重组后处理技术在胃肠间质瘤术前诊断中的应用价值

Application value of 128-slice spiral CT and multi-planar post-processing technology in preoperative diagnosis of gastrointestinal stromal tumor

目的探讨128层螺旋CT检查及多平面重组(MPR)后处理技术在胃肠间质瘤(GIST)术前诊断中的应用价值,为今后的临床诊断工作提供有价值的参考依据。方法选取2017年1月~2019年6月我院收治的20例经手术病理及免疫组织化学证实的GIST患者作为研究对象,对其进行128层螺旋CT检查,并应用MPR后处理技术,以病理及免疫组化结果为依据,统计病灶检出情况、CT检查及MPR后处理技术的定位、定性结果。结果患者经CT检查及MPR后处理技术,检出GIST病灶位于胃部者13例,位于小肠者5例,位于十二指肠者2例;黏膜状态表现为光滑者13例,黏膜存在明显溃疡者7例;囊实性15例,实性5例;增强扫描可观察到肿瘤均匀强化者12例,不均匀强化者8例;均匀强化患者中,病灶确诊为良性者11例,潜在恶性1例;不均匀强化患者中,病灶确诊为良性者2例,恶性者6例。CT检查及MPR后处理技术的定位及定性结果与病理检查比较,差异无统计学意义(P>0.05)。结论128层螺旋CT检查及MPR后处理技术可获得准确的定位与定性结果,具有较高的临床诊断准确率,值得关注并推广。

Objective To analyze the application value of 128-slice spiral CT and multi-planar(MPR)post-processing technology in preoperative diagnosis of gastrointestinal stromal tumor(GIST),so as to valuable reference for clinical diagnosis in the future.Methods From January 2017 to June 2019,20 GIST patients confirmed by surgical pathology and immunohistochemistry were selected as the research objects.A total of 128 slice spiral CT was performed on them,and MPR post-processing technology was applied.Based on the results of pathology and immunohistochemistry,the detection of lesions,the location and qualitative results of CT and MPR post-processing technology were statistically analyzed.Results By CT and MPR post-processing technology,13 cases of gist were located in stomach,5 in small intestine and 2 in duodenum.There were 13 cases of mucosal appearance and 7 cases of obvious ulcer in mucosa.There were 15 cases of solid capsule and 5 cases of solidity.Enhanced scanning revealed 12 cases of uniform tumor enhancement and 8 cases of uneven enhancement.Among the patients with uniform enhancement,11 cases were diagnosed as benign and 1 case was potentially malignant.Among the patients with uneven enhancement,the lesions were diagnosed as benign in 2 cases and malignant in 6 cases.There were no significant differences between the location and qualitative results of CT and MPR post-processing technology and pathological examination(P>0.05).Conclusion 128-slice spiral CT and MPR post-processing technology can obtain accurate localization and qualitative results,and have high clinical diagnostic accuracy,which is worthy of attention and promotion.