多层螺旋CT扫描结合电子胃镜检查对恶性胃溃疡诊断率、灵敏度、准确度的影响

Effect of Multi-Slice Spiral CT Scanning with Electronic Gastroscopy on Diagnostic Rate,Sensitivity and Accuracy of Malignant Gastric Ulcer

目的:探讨多层螺旋CT扫描结合电子胃镜检查在恶性胃溃疡诊断中的可行性。方法:选取2020年3月~2023年3月医院门诊加住院收治的80例疑似恶性胃溃疡患者。全部患者分别行电子胃镜检查、多层螺旋CT扫描。依据病理学检查结果作为金标准,比较多层螺旋CT结合电子胃镜检查、单独多层螺旋CT在胃溃疡诊断中的诊断率、灵敏度和准确度等指标。结果:全部患者中经病理学检查显示,有54例属于恶性胃溃疡,26例属于良性。单独多层螺旋CT鉴别胃溃疡良恶性的诊断率为81.25%,准确度为81.25%,灵敏度为81.48%,特异度为80.77%。多层螺旋CT结合电子胃镜鉴别胃溃疡良恶性的诊断率为92.50%,准确度为92.50%,灵敏度为94.44%,明显高于单独多层螺旋CT,差异有统计学意义(P<0.05);两种技术结合诊断的特异度为84.62%,其与单独多层螺旋CT相比无统计学意义(P>0.05)。扫描特征:胃溃疡中良性病灶呈局限性,增强扫描可见病灶的强化同附近正常黏膜无差别,且附近胃壁有分层。而恶性病灶底部凹凸不平,边缘可见隆起,并侵入附近胃壁,增强扫描可见明显强化征。结论:多层螺旋CT结合电子胃镜在鉴别胃溃疡良恶性时具有良好的优势,可准确筛选出恶性胃溃疡,从而为该病的早期干预奠定基础。

Objective:To explore the feasibility of multi-slice spiral CT scanning with electronic gastroscopy on the diagnosis of malignant gastric ulcer.Methods:From March 2020 to March 2023,80 patients with suspected malignant gastric ulcer were selected.All patients underwent electronic gastroscopy and multi-slice spiral CT scanning respectively.According to the results of pathological examination as the gold standard,the diagnostic rate,sensitivity and accuracy of multislice spiral CT with electronic gastroscopy and single multi-slice spiral CT on the diagnosis of gastric ulcer were compared.Results:Pathological examination showed that 54 cases were malignant gastric ulcer and 26 cases were benign.The diagnostic rate,accuracy,sensitivity and specificity of single multi-slice spiral CT on differentiating benign from malignant gastric ulcer were 81.25%,81.25%,81.48%and 80.77%.The diagnostic rate of multi-slice spiral CT with electronic gastroscope on differentiating benign from malignant gastric ulcer was 92.50%,the accuracy was 92.50%,and the sensitivity is 94.44%,which were significantly higher than those of multi-slice spiral CT alone(P<0.05).The specificity of combined diagnosis was 84.62%,which was not statistically significant compared with the single multi-slice spiral CT(P>0.05).Benign lesions in gastric ulcer were localized.Enhanced scanning showed that there was no difference between the enhancement of lesions and the nearby normal mucosa,and there was stratification in the nearby gastric wall.The bottom of malignant lesions was uneven,and the edge could be seen protruding,and it invaded the nearby stomach wall,and obvious enhancement signs could be seen in enhanced scanning.Conclusion:Multi-slice spiral CT with electronic gastroscope has the good advantage on differentiating benign from malignant gastric ulcer,which can accurately screen out malignant gastric ulcer,thus laying the foundation for early intervention of the disease.