多层螺旋CT、内镜诊断胃脂肪瘤的效能分析  

Application and Efficacy Analysis of MSCT and Endoscopy in the Diagnosis of Gastric Lipoma

作　　者：张印霞 郭山山 李楠楠 邓金花 ZHANG Yin-xia;GUO Shan-shan;LI Nan-nan(Department of Imaging,the Third People’s Hospital of Henan Province 450000)

机构地区：[1]河南省直第三人民医院影像科,河南郑州450000

出　　处：《医学临床研究》2021年第2期185-188,共4页Journal of Clinical Research

基　　金：河南省医学科学研究基金(项目编号:YWJKJJHKYJJ-A105)。

摘　　要：[目的]探讨多层螺旋CT(MSCT)及内镋检查诊断胃脂肪瘤的效能。【方法】本院收治的疑似为胃脂肪瘤的患者46例,经手术病理证实33例为胃脂肪瘤,13例为胃淋巴瘤。所有患者均于术前行内镜及MSCT检查。观察胃脂肪瘤MSCT及内镜检查及病理学检查表现;运用受试者工作特征曲线(ROC)分析内镜及MSCT诊断胃脂肪瘤的效能。【结果】(1)MSCT检查患者均为单发病灶,病灶边界清楚,密度均匀,其中22例(66.67%)位于胃窦部.胃体8例(24.24%),胃底3例(9.09%),其中2例(6.06%)胃窦部脂肪瘤合并降结肠脂肪瘤;肿瘤形态显示,胃脂肪瘤平扫显示边界清晰,呈类圆形或椭圆形,呈不均匀的或均匀的低密度,动态三期增强扫描强化均不明显;(2)内镜检查显示23例(69.70%)发现病灶,其中17例(73.92%)表现为局部胃肠道黏膜下局部隆起,3例(13.04%)肠套叠者可见肠道团块样占位,3例(13.04%)病灶表面可见黏膜溃破出血;(3)ROC曲线分析显示,MSCT诊断胃脂肪瘤的AUC为0.887,高于内镋检查诊断的0.774,两者联合检查诊断胃脂肪瘤的效能高于任一单一指标诊断。【结论】MSCT对胃脂肪瘤的形态、性质、大小等能够做出清楚判断,诊断胃脂肪瘤的效能较高;内铣检查能够清楚显示病灶形态及局部胃黏膜状况,对胃脂肪瘤具有一定诊断价值;MSCT及内镜联合检查可明显提高诊断胃脂肪瘤的准确性。[Objective]To investigate the characteristics of gastric lipoma by multi-slice spiral CT(MSCT)and endo­scopic examination in the diagnosis of gastric lipoma.[Methods]A total of 46 patients with suspected gastric lipoma ad­mitted to our hospital were selected as subjects.Of which,33 cases of gastric lipoma were confirmed by operation and pa­thology,and 13 cases were gastric lymphoma.All patients underwent endoscopic and MSCT examination before operation.The MSCT,endoscopic and pathological findings of gastric lipoma were observed.The receiver operating characteristic curve(ROC)was used to analyze the efficacy of endoscopy and MSCT in the diagnosis of gastric lipoma.[Results](1)All patients with MSCT here showed single lesion with clear border and uniform density.Among them,22 cases(66.67%)were located in the gastric antrum,8 cases(24.24%)in gastric body,3 cases(9.09%)in gastric fundus.Only 2 cases(6.06%)had lipoma in both gastric antrum and descending colon.Tumor morphology showed that a clear bounda­ry,round or oval shape and uneven or uniform low density by plain scan;the enhancement by dynamic three-phase en­hanced scan was not obvious.(2)Endoscopic examination showed that lesions were found in 23 cases(69.70%).Of which,17 cases(73.92%)showed local submucosal local eminence in the local gastrointestinal tract,3 cases(13.04%)intussusception showed intestinal lump like occupying,and 3 cases(13.04%)showed mucosal rupture bleeding on the surface of the lesion.(3)ROC curve analysis showed that the AUC of MSCT in diagnosing gastric lipoma was 0.887,which was higher than 0.774 in endoscopy.The combined examination of MSCT and endoscopy for diagnosis of gastric lipoma was more effective than any single index.[Conclusion]MSCT can make a clear judgement for gastric lipoma based on the image of shape,nature and size of the lesions.Endoscopy can clearly show the shape of the lesion and the local gas­tric mucosa,which has a certain diagnostic value for gastric lipoma.Combined both MSCT and endoscopy can improve the ac

关 键 词：胃肿瘤/诊断 体层摄影术 X线计算机 内窥镜检查 

分 类 号：R735.2[医药卫生—肿瘤]