基于增强CT的影像学模型对低危险度胃间质瘤与胃平滑肌瘤的鉴别诊断价值  

The value of imaging model based on enhanced CT in the differential diagnosis of low risk gastric stromal tumor and gastric leiomyoma

作　　者：范莉芳 黄磊 翟建[2] 肖良 徐晓燕 徐争元 吴树剑 FAN Li-fang;HUANG Lei;ZHAI Jian;XIAO Liang;XU Xiao-yan;XU Zheng-yuan;WU Shu-jian(Department of Medical Imaging,Wannan Medical College,Wuhu Anhui 241000,China;Yijishan Hospital Affiliated to Wannan Medical College,Wuliu Anhui 241001,China)

机构地区：[1]皖南医学院医学影像学院,安徽芜湖241000 [2]皖南医学院附属弋矶山医院,安徽芜湖241001

出　　处：《中国临床医学影像杂志》2022年第4期268-272,共5页Journal of China Clinic Medical Imaging

基　　金：安徽高校自然科学研究项目(KJ2017A259);皖南医学院中青年科研基金(WK202003)。

摘　　要：目的:探讨基于增强CT的影像学模型对低危险度胃间质瘤(Low risk gastric stromal tumor,LRGST)与胃平滑肌瘤(Gastric leiomyomas,GLMs)的鉴别诊断价值。方法:回顾性分析2015年1月—2021年2月于皖南医学院一附院经手术病理及免疫组化证实的72例LRGST(LRGST组)和23例GLMs(GLMs组)患者的CT图像。测量肿瘤最大径(LD)及最小径(SD),肿瘤及邻近胃壁增强三期CT值,肿瘤及椎旁肌肉平扫及增强三期不均匀度(HD)。记录肿瘤生长方式及是否累及胃食管连接部(EGJ),计算肿瘤的LD/SD、各期强化率(ERT)及标准化不均匀率(SHRT)。构建CT诊断模型,绘制受试者工作特征(ROC)曲线,评价模型的诊断效能。结果:LRGST组与GLMs组肿瘤的SD、LD/SD、生长方式、是否累及EGJ、延迟期ERT、静脉期及延迟期SHRT间差异有统计学意义(P<0.05);LRGST组SHRT与打药时间显著相关(r=0.341,P=0.000);CT诊断模型ROC曲线的AUC为0.948,敏感度为88.9%,特异性为91.3%。结论:基于SD、LD/SD、生长方式、是否累及EGJ、延迟期ERT、静脉期及延迟期SHRT的不同建立的影像学模型对LRGST与GLMs有很高的敏感度和特异性。Objective:To evaluate the value of imaging model based on enhanced CT in the differential diagnosis of low risk gastric stromal tumor(LRGST)and gastric leiomyoma(GLMs).Methods:The CT images of 72 cases of LRGST(LRGST group)and 23 cases of GLMs(GLMs group)confirmed by operation,pathology and immunohistochemistry in the First Affiliated Hospital of Wannan Medical College from January 2015 to February 2021 were analyzed retrospectively.The maximum diameter(LD),minimum diameter(SD),enhanced CT value of tumor and adjacent gastric wall,plain scan of tumor and paraspinal muscles and enhanced inhomogeneity(HD)were measured.We record the growth pattern of the tumor and whether the esophagogastric junction(EGJ),was involved or not.The LD/SD,enhancement rate(ERT)and standardized heterogeneous rate(SHRT)of the tumor were calculated.The CT diagnostic model was constructed,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficiency of the model.Results:There were significant differences in SD,LD/SD,growth pattern,EGJ involvement,delayed ERT,venous phase and delayed SHRT between LRGST group and GLMs group(P<0.05);There was a significant correlation between SHRT and administration time in LRGST Group(r=0.341,P=0.000).The AUC,sensitivity and specificity of ROC curve of CT diagnostic model were 0.948,88.9%and 91.3%,respectively.Conclusion:The imaging models established by SD,LD/SD,growth pattern,EGJ involvement,delayed ERT,venous phase and delayed SHRT have high sensitivity and specificity for LRGST and GLMs.

关 键 词：胃肿瘤 平滑肌瘤 体层摄影术 螺旋计算机 

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