增强CT在鉴别胃神经鞘瘤和胃间质瘤中的价值

The role of contrast-enhanced CT in differentiating gastric neurinoma from gastric stromal tumor

目的分析胃神经鞘瘤的增强CT表现,并探讨其与胃间质瘤的鉴别诊断。方法选取17例胃神经鞘瘤和88例胃间质瘤的增强CT图像,观察并记录肿瘤的位置、生长方式、大小、轮廓、均质性、溃疡、坏死、出血、钙化、肿大淋巴结、强化峰值、强化程度,采用卡方检验比较两者间的差异。结果17例胃神经鞘瘤发生在胃体8例、胃窦9例,生长方式为腔内外型5例、腔外型12例,大部分轮廓光整14例、成分均质13例,强化峰度以延迟期为主14例,多表现为中、高度的强化(分别为10例、6例)。胃神经鞘瘤与胃间质瘤在病灶位置、生长方式、均质性、是否存在坏死以及强化峰度的比较,差异有统计学意义(P<0.05)。结论胃神经鞘瘤可表现出一些特征性的增强CT表现,与胃间质瘤存在一定的差异。

Objective To investigate the imaging findings of gastric neurinoma(GN)in contrast-enhanced CT,and to explore the differential diagnosis between GN and gastric stromal tumor(GST).Methods 17 cases of GNs and 88 cases of GSTs with contrast-enhanced CT images were retrospectively collected.The location,growth pattern,size,contour,homogeneity,ulcer,necrosis,hemorrhage,calcification,enlarged lymph node,enhanced peak period,and enhanced degree of tumors were observed and recorded.Chi-square test was performed to compare GNs with GSTs.Results All the 17 GNs located in gastric body(8 cases)or antrum(9 cases).Their growth patterns were exophytic(12 cases)or mixed types(5 cases).Most of the lesions presented as regular shape(14 cases)and homogeneous component(13 cases).The enhanced peak period of GNs mainly happened in delayed phase,and the enhanced degree was medium to high mostly.The tumor location,growth pattern,homogeneity,necrosis,and enhanced peak period were significantly different between GNs and GSTs(P<0.05).Conclusion GNs could show a few characteristic imaging features in contrast-enhanced CT,and they may be different from GST.