充气CT对上消化道黏膜下病变的诊断价值  

Value of Pneumatic CT in the Diagnosis of Upper Gastrointestinal Submucosal Lesions

作　　者：王艳红[1] 李德亮 WANG Yanhong;LI Deliang(Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院消化内科,河南郑州450000

出　　处：《河南医学研究》2021年第17期3213-3217,共5页Henan Medical Research

摘　　要：目的探讨充气CT对上消化道黏膜下病变的诊断价值。方法选取2019年1-12月于郑州大学第一附属医院消化内科接受普通CT、充气CT、超声胃镜检查及病理检查的68例患者,以病理结果为金标准,比较3种检查的诊断结果,探讨充气CT的诊断价值。结果68例患者中病理结果显示57例(83.8%)为阳性,其中平滑肌瘤23例,间质瘤22例,神经内分泌瘤8例,脂肪瘤4例。以病理诊断为金标准,普通CT共诊断33例阳性病例,诊断效能较低(Kappa=0.135,0.123),充气CT共诊断54例阳性病变,诊断效能一般(Kappa=0.658,P<0.001),超声胃镜诊断阳性病变55例,诊断效能较高(Kappa=0.798,P<0.001)。ROC曲线显示,常规CT、充气CT、超声胃镜AUC分别为0.627、0.865、0.928,充气CT与超声胃镜AUC差异无统计学意义(P=0.631),二者AUC均大于常规CT(P<0.001)。结论充气CT对上消化道黏膜下病变的诊断价值高于普通CT,诊断效能接近超声胃镜,可作为一种经济、有效的上消化道黏膜下病变筛查方法或不能接受胃镜检查的替代检查方法。Objective To explore the diagnostic value of pneumatic CT for submucosal lesions of the upper gastrointestinal tract.Methods A total of 68 patients who received common CT,pneumatic CT,ultrasound gastroscopy and pathological examinations in the Gastroenterology Department of the First Affiliated Hospital of Zhengzhou University from January to December 2019 were the research objects.With pathological results as the gold standard,the diagnostic results of the three tests were compared and the diagnostic value of pneumatic CT was discussed.Results Of the 68 patients,57(83.8%)were found to be positive by pathology,including 23 leiomyomas,22 stromal tumors,8 neuroendocrine tumors,and 4 lipomas.A total of 33 positive cases were diagnosed by common CT,and the diagnostic efficiency was low(Kappa=0.135,P=0.123).A total of 54 positive cases were diagnosed by pneumatic CT,and the diagnostic efficiency was average(Kappa=0.658,P<0.001).Fifty-five cases were diagnosed positively by ultrasound gastroscopy,and the diagnostic efficiency was high(Kappa=0.798,P<0.001).The ROC curve showed that the AUC of common CT,pneumatic CT,and ultrasound gastroscopy were 0.627,0.865,and 0.928,respectively.There was no significant difference in AUC between pneumatic CT and ultrasound gastroscopy(P=0.631),and the AUC of the former two were both greater than that of common CT(P<0.001).Conclusions The diagnostic value of pneumatic CT for submucosal lesions of the upper gastrointestinal tract is higher than that of common CT,and its diagnostic efficiency is close to that of ultrasound gastroscopy.It could be used as an economical and effective screening method for submucosal lesions of the upper gastrointestinal tract,or an alternative examination method for those who cannot accept gastroscopy.

关 键 词：上消化道 黏膜下病变 充气CT 诊断价值 

分 类 号：R445.3[医药卫生—影像医学与核医学]