CT征象鉴别肠道良恶性疾病的临床价值

Clinical Value of CT Signs in Distinguishing Benign and Malignant Intestinal Tract Diseases

目的 探究CT征象鉴别肠道良恶性疾病的临床价值。方法 选取2018年6月至2019年8月我院消化内科收治的96例疑似胃肠道间质瘤患者进行研究。患者均行CT扫描。评估胃肠道间质瘤良恶性。结果 病理诊断胃肠道恶性间质瘤31例,CT诊断30例与其结果一致,有1个误判为良性间质瘤;病理诊断胃肠道良性间质瘤65例,CT诊断58例与其结果一致,有7个误判为恶性间质瘤。恶性肿瘤组直径>5cm、病灶在肠道、病灶边缘模糊或分叶、密度不均匀、发生侵犯和转移占比高于良性肿瘤组,差异显著(P<0.05)。CT诊断胃肠道良恶性间质瘤灵敏度(96.78)、特异度(89.23)、阳性预测值(81.08)、阴性预测值(98.31)、准确率(91.67%),与病理诊断一致性(Kappa=0.819)。结论 CT征象鉴别肠道良恶性疾病准确性较高,且与病理结果具有较好的一致性,为患者病情诊断提供有效依据。

Objective To explore the clinical value of CT signs in identifying benign and malignant intestinal tract diseases. Methods Between June 218 and August 2019, 96 patients with suspected gastrointestinal stromal tumors admitted to our hospital were enrolled for CT scan. The benign and malignant features of gastrointestinal stromal tumors were assessed. Results Pathological diagnosis of gastrointestinal malignant stromal tumors in 31 cases was consistent with CT diagnosis of 30 cases, and one was misdiagnosed as benign stromal tumor. Pathological diagnosis of gastrointestinal benign stromal tumors in 65 cases was consistent with CT diagnosis of 58 cases, but there were 7 cases misdiagnosed as malignant stromal tumors. The diameter >5cm, the intestinal lesion, the blurred or lobed margin,uneven density, and the proportion of invasion and metastasis were higher in the malignant tumor group than those in the benign tumor group(P<0.05). The clinical value of CT in gastrointestinal benign and malignant stromal tumors was as follows: Sensitivity(96.78), specificity(89.23), positive predictive value(81.08), negative predictive value(98.31), accuracy rate(91.67%), agreement with pathological diagnosis(Kappa = 0.819, P<0.001). Conclusion CT signs are more accurate in identifying benign and malignant intestinal diseases with high consistency with pathological results, which lays an effective basis for the diagnosis of patients’ condition.