多排螺旋CT对胃平滑肌瘤与胃神经鞘瘤的鉴别诊断价值  

The value of multiple-row helical CT in differential diagnosis of the gastric leiomyoma and gastric schwannoma

作　　者：舒俊[1] 孟小丽[2] 唐永强[1] 文娣娣[1] 张广文[1] 张瑜[1] 张劲松[1] 

机构地区：[1]第四军医大学附属西京医院放射科,陕西西安710032 [2]陕西中医药大学医学技术学院,陕西咸阳712046

出　　处：《医学影像学杂志》2016年第8期1435-1438,共4页Journal of Medical Imaging

摘　　要：目的探讨多排螺旋CT对胃平滑肌瘤与胃神经鞘瘤的鉴别诊断价值。方法回顾性分析我院经手术病理及免疫组化证实,CT资料完整的22例胃平滑肌瘤及16例胃神经鞘瘤,采用两样本t检验分析瘤体的长径、长短径之比数据、静脉期CT值并绘制ROC曲线得到最佳诊断值。采用Fisher’s确切概率法分析发病部位、生长方式、形态、粘膜强化、钙化、强化程度。结果与胃神经鞘瘤相比,胃平滑肌瘤好发于贲门,多向腔内生长,增强扫描轻度强化,长径≤3.2cm,长径/短径>1.2,静脉期CT值<65HU(P<0.05)。用长径≤3.2cm、长径/短径>1.2、静脉期CT值≤63HU作为标准,敏感度依次为86.4%、81.82%、95.24%,特异度依次为62.5%、81.25%、56.24%。结论使用以上特异的CT标准鉴别胃平滑肌瘤与胃神经鞘瘤有很高的准确性。Objective To explore the value of multiple-row helical CT in differential diagnosis of the gastric leiomyoma and gastric schwannoma. Methods CT findings of 22 gastric leiomyomas and 16 gastric schwannomas were retrospectively analyzed. All of the cases were confirmed by pathology immunohisto-chemistry after surgery. The CT features including long diameters （LD） , the ratio of LD and short diameters（SD） and the CT value in venous phase were recorded and analyzed by group t-test, and the location, growth pattern, contour, enhancement of overlying mucosa, calcification, degree of contrast enhancement were recorded and nanlyzed by Fisher＇ s exact test. Results Located in eardia, endoluminal growth,low enhancement, LD ≤ 3.2 cm, LD/SD ratio 〉 1.2, CT value in venous phase 〈 65 HU were siginificant findings for differential leiomyomas from schwannomas （ P 〈0.05 for each finding）. An LD ≤ 3.2 cm, LD/SD ratio 〉 1.2, CT value in venous phase 〈 65 HU yielded sensitivity of 86.4%, 81.2%, 95.24% and specificities of 62.5%, 81.25%, and 56.24%. Conclusion By using the specific CT criteria, gastric leiomyomas and gastric schwannomas can be differentiated from each other with a high degree of accuracy.

关 键 词：胃 平滑肌瘤 神经鞘瘤 体层摄影术 x线计算机 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]