CT多期增强对预测小肠间质瘤危险度分级的诊断价值研究

Value of Multi-Phase Enhanced CT in the Risk Stratification of Small Intestinal Stromal Tumors

目的探讨多期增强CT对预测小肠间质瘤(GIST)危险度分级的诊断价值。方法回顾性分析经病理证实的84例小肠GIST,比较高危、中危及低危小肠GIST的CT影像学特征,并采用单因素方差分析比较不同危险程度的小肠GIST容积平均CT值的差异。结果高危组小肠GIST肿瘤体积更大,更容易出现坏死、出血。无论是在动脉期还是静脉期,肿瘤的容积CT值均值随着危险度的增高而减低,高危组的CT值平均值显著低于低危组(P<0.001)。在静脉期,中危组的CT值平均值显著低于低危组(P=0.030)。结论CT多期增强扫描能够提供区分不同危险等级的小肠GIST的重要影像学特征信息,综合分析小肠GIST肿瘤大小、异质性及容积CT值,能够帮助预测肿瘤的危险程度,为临床治疗提供更有价值的影像学信息。

Objective To explore the diagnostic value of multi-phase enhanced CT in predicting the risk stratification of small bowel gastrointestinal stromal tumors(GIST).Methods A retrospective analysis of 84 cases of small bowel GISTs confirmed by pathology was performed to compare the CT features of high-risk,mediumrisk and low-risk small bowel GISTs.Volumetric CT value of small bowel GISTs with different risk levels was compared by using One-way ANOVA.Results In the higher risk group,small bowel GISTs were larger and more prone to necrosis and hemorrhage.Both in the arterial and venous phase,the mean CT value decreased with increasing risk.The mean CT value of the high-risk group is significantly lower than that of the low-risk group(P<0.001).In the venous phase,the mean CT value of the medium-risk group was significantly lower than that of the low-risk group(P=0.030).Conclusion Multi-phase enhanced CT can provide important information for predicting the risk levels of small bowel GISTs.Comprehensive analysis of tumor size,heterogeneity,and volumetric CT value can help predict the risk level and provide suggestions for clinical treatment.