直径≤5cm胃间质瘤、胃神经鞘瘤CT多期扫描特点及鉴别价值

Characteristics and Differential Value of Multi-phase CT Scanning for Gastric Stromal Tumor and Gastric Schwannoma with Diameter≤5cm

目的分析直径≤5cm胃间质瘤(GIST)、胃神经鞘瘤(GS)计算机X线断层扫描(CT)多期扫描特点及鉴别价值。方法回顾性分析我院实施CT多期扫描检查的60例存在直径≤5cm且疑似GIST或GS患者,以手术病理结果作为金标准,分析CT多期扫描鉴别直径≤5cm的GIST、GS的准确度、敏感度、特异度。由放射科医师对CT检查影象中扫描特点(病灶位置、肿瘤形态、生长方式、密度、边界、组织坏死、组织钙化、组织溃疡)进行分析比较。结果CT多期扫描鉴别直径≤5cm的GIST、GS的准确度为95.00%(57/60),敏感度为98.11%(52/53),特异度为71.43%(5/7),阳性预测值为96.30%(52/54),阴性预测值为83.33%(5/6),Kappa为0.741。CT多期扫描特征中,直径≤5cm的GIST、GS在肿瘤形态、边界情况比较差异无统计学意义(P<0.05);在病灶位置、生长方式、密度、边界、组织坏死、组织钙化、组织溃疡情况比较差异无统计学意义(P>0.05)。结论直径≤5cm的GIST、GS以CT多期扫描进行检查鉴别时,二者在肿瘤形态、边界扫描特点有明显差异,具有一定鉴别诊断价值,为临床鉴别诊断提供参考依据。

Objective To analyze the characteristics and differential value of multi-phase computed tomography(CT)for gastric stromal tumor(GIST)and gastric schwannoma(GS)with diameter≤5cm.Methods A total of 60 patients with suspected GIST or GS with diameter≤5cm who underwent multi-phase CT scanning were retrospectively analyzed.Taking the surgical and pathological results as the gold standard,the accuracy,sensitivity and specificity of multi-phase CT scanning in discriminating GIST and GS with diameter≤5cm were analyzed.The scanning characteristicsof CT images(lesion location,tumor morphology,growth mode,density,boundary,tissue necrosis,tissue calcification,tissue ulcer)were analyzed and compared by radiologists.Results The accuracy,sensitivity,specificity,positive predictive value,negative predictive value and Kappa value of GIST and GS with diameter≤5cm were 95.00%(57/60),98.11%(52/53),71.43%(5/7),96.30%(52/54),83.33%(5/6)and 0.741 respectively.Among the characteristics of multi-phase CT scanning,there were significant differences in tumor morphology and border between GIST and GS with diameter≤5cm(P<0.05).There were no significant differences in lesion location,growth pattern,density,boundary,tissue necrosis,tissue calcification and tissue ulcer(P>0.05).Conclusions When GIST and GS with diameter≤5cm are examined and differentiated by multi-phase CT scanning,there are obvious differences in tumor morphology and boundary scan characteristics between them,which has certain differential diagnostic value and provides reference basis for clinical differential diagnosis.