增强CT检查对胃异位胰腺和胃间质瘤的鉴别价值

Differential Value of Enhanced CT in Gastric Ectopic Pancreas and Gastric Stromal Tumor

目的 分析胃异位胰腺与胃间质瘤的临床和CT特征,以探讨可以鉴别二者的CT参数。方法 回顾性2013年1月至2021年12月所有组织学证实的胃异位胰腺患者和2018年1月至2021年12月的胃间质瘤患者的临床资料。比较胃异位胰腺与胃间质瘤的临床和CT资料差异。使用Logistic回归分析病变CT特征与胃间质瘤的关系。使用ROC曲线构建鉴别二者的诊断曲线。结果 与胃异位胰腺相比,胃间质瘤患者平均年龄更大、存在相关症状比例更高、更高比例血清肿瘤标志物异常(P<0.05)。胃间质瘤病变位置多位于胃体(46.85%)和胃底(34.26%),胃异位胰腺多位于胃体内(65.00%),胃间质瘤患者的CT成像显示更高比例的坏死、钙化和更低比例的瘤周渗出(P<0.05)。ROC曲线显示病灶静脉期的CT值对鉴别间质瘤和异位胰腺具有最大曲线下面积,为0.921。结论 胃间质瘤与胃异位胰腺具有不同的CT特征,病灶静脉期的CT值对胃异位胰腺与间质瘤具有较高的鉴别效能。

Objective To analyze the clinical and CT features of gastric ectopic pancreas and gastric stromal tumor,and to explore the CT parameters that can distinguish them.Methods The clinical data of all patients with histologically confirmed gastric ectopic pancreas from January 2013 to December 2021 and patients with gastric stromal tumor from January 2018 to December 2021 were reviewed.To compare the clinical and CT data of gastric ectopic pancreas and gastric stromal tumor.Logistic regression was used to analyze the relationship between CT features of lesions and gastric stromal tumors.The ROC curve was used to construct the diagnostic curve to distinguish them.Results Compared with gastric ectopic pancreas,patients with gastric stromal tumor had a higher age,a higher proportion of related symptoms and abnormal serum tumor markers(P<0.05).The lesions of gastric stromal tumors were mostly located in the gastric body(46.85%)and gastric fundus(34.26%),and the ectopic pancreas was mostly located in the stomach(65.00%).CT imaging of patients with gastric stromal tumors showed a higher proportion of necrosis,calcification and a lower proportion of peritumoral exudation(P<0.05).The ROC curve showed that the CT value in the venous phase of the focus had the largest area under the curve(0.921)to distinguish between stromal tumor and ectopic pancreas.Conclusion Gastric stromal tumor and gastric ectopic pancreas have different CT features.The CT value in the venous phase of the focus has a high differential efficiency between gastric ectopic pancreas and stromal tumor.