MSCT对胃异位胰腺和胃间质瘤的鉴别诊断  

MSCT in differential diagnosis of gastric ectopic pancreas and gastric stromal tumor

作　　者：贾镕泽 王海燕 郭守辉 JIA Rongze;WANG Haiyan;GUO Shouhui(School of Public Health of Cheeloo College of Medicine,Shandong University,Jinan 250012,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]山东第一医科大学附属省立医院医学影像科,山东济南250021 [3]山东大学齐鲁医学院公共卫生学院,山东济南250012 [4]国家健康医疗大数据研究院,山东济南250003

出　　处：《中国中西医结合影像学杂志》2023年第4期432-435,439,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:分析胃异位胰腺和胃间质瘤的MSCT表现,以期实现术前明确诊断。方法:回顾性分析40例胃异位胰腺和54例胃间质瘤(长径≤3 cm)患者的临床和MSCT表现,对比2组患者年龄、病灶大小、位置、形状、边界、生长方式、周围黏膜连续性、黏膜强化线、中央脐凹征、中央导管征、瘤周脂线、钙化、各期CT值及强化程度,以及胃异位胰腺和自身主胰腺的CT平扫和增强扫描表现。结果:2组患者的年龄和病灶的长短径比值、位置、形状、边界、中央脐凹征比较,差异均有统计学意义(均P<0.001)。胃异位胰腺平扫、动脉期、静脉期CT值均高于胃间质瘤,差异均有统计学意义(均P<0.05);胃异位胰腺动脉期多呈明显强化,而胃间质瘤多呈轻中度强化,两者强化程度差异有统计学意义(P<0.05)。胃异位胰腺平扫、动脉期CT值均低于主胰腺,且两者动脉期和延迟期强化程度不同,差异均有统计学意义(均P<0.05)。结论:胃异位胰腺和长径≤3 cm胃间质瘤的MSCT表现有一定的特征性,且胃异位胰腺与自身主胰腺的MSCT表现不同,结合患者年龄,对胃异位胰腺和胃间质瘤的鉴别诊断有一定的价值。Objective:To explore the value of MSCT features in the differential diagnosis of gastric ectopic pancreas(GEP)and gastric stromal tumor(GST).Methods:The clinical data and MSCT features of 40 GEP patients and 54 GST patients with lesions≤3 cm were retrospectively analyzed.The age and CT findings of the two groups were compared,including long diameter,short diameter,the ratio of long diameter to short diameter(LD/SD),contour,location,border,growth pattern,mucosa continuity,prominent enhancement of overlying mucosa,surface dimple,central catheter sign,peritumoral fat-line,the CT value and enhancement grade of each stage.The CT value and enhancement grade between the GEP and pancreas were compared.Results:There were significant differences in age,LD/SD,contour,location,border and surface dimple between the two groups(all P<0.05).The CT values of GEP in the plain scan and arterial and venous phases were higher than those of GST,and in the arterial stage,most GEP showed significant enhancement,while most GST showed mild to moderate enhancement,the differences were statistically significant(all P<0.05).The CT values of GEP in the plain scan and arterial phase were lower than those of GST,while the enhancement attenuation values in the venous and delayed phases were higher than those of the pancreas.GEP and the pancreas showed different enhancement grades in the arterial and delayed phases,and the differences were statistically significant(all P<0.05).Conclusions:MSCT findings of GEP and GST with a long diameter≤3 cm have certain characteristics,and MSCT findings of GEP are different from those of the main pancreas.Combined with the age of patients,it is of certain value in the differential diagnosis of GEP and GST.

关 键 词：异位胰腺 胃肠道间质瘤 体层摄影术 X线计算机 影像组学 

分 类 号：R735[医药卫生—肿瘤]