多层螺旋CT对肿瘤直径≤5 cm胃间质瘤和胃神经鞘瘤的鉴别诊断价值

The value of multi-slice spiral CT in the differential diagnosis of gastric stromal tumor and gastric schwannoma with diameter≤5 cm

目的探讨多层螺旋计算机断层扫描(MSCT)对肿瘤直径≤5 cm胃间质瘤和胃神经鞘瘤的诊断价值。方法选取胃间叶源性肿瘤患者92例,其中,胃间质瘤患者72例,胃神经鞘瘤患者20例,给予MSCT检查,对胃间质瘤和胃神经鞘瘤的CT征象进行比较,分析MSCT对肿瘤直径≤5 cm胃间质瘤和胃神经鞘瘤的诊断价值。结果胃间质瘤形态呈分叶状、边界模糊的比例均明显高于胃神经鞘瘤,差异均有统计学意义(P﹤0.01)。胃间质瘤和胃神经鞘瘤平扫期、动脉期、静脉期和延迟期的CT值比较,差异均无统计学意义(P﹥0.05)。高危胃间质瘤形态呈分叶状、密度不均匀、边界模糊的比例均明显高于低中危胃间质瘤,差异均有统计学意义(P﹤0.05)。不同危险分级胃间质瘤患者的CT值比较,差异均无统计学意义(P﹥0.05)。与病理诊断结果对照,MSCT诊断肿瘤直径≤5 cm胃间质瘤的灵敏度、特异度、阳性预测值和阴性预测值分别为66.67%(48/72)、70.00%(14/20)、88.89%(48/54)和36.84%(14/38)。结论肿瘤直径≤5 cm胃间质瘤和胃神经鞘瘤的MSCT征象存在差异,MSCT对二者具有一定的鉴别诊断价值。

Objective To investigate the value of multi-slice spiral CT(MSCT)in the differential diagnosis of gastric stromal tumor and gastric schwannoma with diameter≤5 cm.Method Ninety-two cases of gastric mesenchymal tumor were selected,including 72 cases of gastric stromal tumor and 20 cases of gastric schwannoma.MSCT examination was given to analyze and compare the CT signs of gastric stromal tumor and gastric schwannoma,the diagnostic value of MSCT in gastric stromal tumor and gastric schwannoma with tumor diameter≤5 cm was analyzed.Result The proportion of gastric stromal tumor with lobulated shape and fuzzy boundary was significantly higher than that of gastric schwannoma(P<0.01).There were no significant differences in CT value of plain scan,arterial phase,venous phase and delayed phase between gastric stromal tumor and gastric schwandoma(P>0.05).The proportion of high-risk gastric schwannoma with lobulated shape,uneven density and fuzzy boundary was significantly higher than that of low-risk and medium-risk gastric stromal tumor(P<0.05).There was no significant difference in CT value among patients with different risk grades of gastric schwannoma(P>0.05).Compared with pathological diagnosis,the sensitivity,specificity,positive predictive value and negative predictive value of MSCT in the diagnosis of gastric schwannoma were 66.67%(48/72),70.00%(14/20),88.89%(48/54)and 36.84%(14/38),respectively.Conclusion In the diagnosis of diameter≤5 cm gastric stromal tumor and gastric schwannoma,there are differences in MSCT signs between them,which is of certain value in differential diagnosis.