CT定量特征在鉴别长径<3 cm的胃间质瘤与异位胰腺中的价值  

The Value of CT Quantitative Features in Differentiating Gastric Stromal Tumors Less Than 3 cm in Length From Heterotopic Pancreas

作　　者：张艺凡 万娅敏[1] 师佳佳 陈云锦 雷丽敏 郭晓旭 高剑波[1] ZHANG Yifan;WAN Yamin;SHI Jiajia(Department of Radiology,the First Affiliated Hospital of Zhengzhou Universiyt,Zhengzhou,Henan Province 450052,P.R.China)

机构地区：[1]郑州大学第一附属医院放射科,450052

出　　处：《临床放射学杂志》2024年第5期831-835,共5页Journal of Clinical Radiology

摘　　要：目的 探讨CT定量特征对长径<3 cm的胃间质瘤与异位胰腺的鉴别诊断价值。方法 回顾性分析经手术病理证实的123例胃间质瘤和57例胃异位胰腺患者的临床信息、病理结果及影像学检查资料,采用卡方检验比较两组患者定性参数(性别、部位等),采用两独立样本t检验比较两组患者定量参数(年龄、动脉比等)。应用二元Logistic回归模型筛选出胃间质瘤与异位胰腺的独立预测因素,并采用受试者操作特征曲线(ROC)分析CT特征鉴别间质瘤和异位胰腺的诊断效能。结果 异位胰腺患者与间质瘤患者相比,多为男性(63.2%vs. 34.1%),年龄较小[(37.6±10.0)岁vs.(57.4±10.0)岁],肿瘤多位于胃窦(84.4%vs. 61.5%),强化均匀、明显,病灶成分多为实性(89.5%vs. 48.8%、53.9%vs. 24.4%、 94.7%vs. 61.0%),长径/短径较大[(1.5±0.4) cm vs.(1.3±0.2) cm],动脉CT值较大[(82.6±11.2) HU vs.(63.4±11.7) HU],动脉比、动脉强化率较大[(220.9±58.4)%vs.(186.9±49.9)%,(120.9±58.4)%vs.(86.9±49.9)%],差异均有统计学意义(均P<0.05)。二元Logistic回归模型分析结果显示,诊断胃间质瘤与异位胰腺的独立预测因素包括性别、年龄、长径/短径、动脉强化率。长径/短径、动脉强化率的诊断最佳阈值分别为1.23、0.42,可作为二者鉴别的参考值。当联合性别、年龄、长径/短径、动脉强化率等进行ROC曲线分析时,其曲线下面积为0.959,诊断敏感度、特异度分别为87.7%、91.1%。各独立预测因素和联合诊断模型的ROC曲线分析结果显示:性别、年龄、长径/短径、动脉强化率和联合诊断模型的曲线下面积分别为0.645、0.912、0.659、0.663、0.959,联合诊断模型具有较高的诊断效能(P<0.001)。结论 性别、年龄、长径/短径、动脉强化率等CT特征可用于鉴别胃间质瘤与异位胰腺。Objective To explore the value of quantitative features of CT in the differential diagnosis of gastric stromal tumors(GST) with a diameter of less than 3 cm and heterotopic pancreas(HP).Methods The clinical information,pathological findings and imaging data of 123 cases of GST and 57 cases of HP confirmed by surgical pathology in our hospital from January 2020 to February 2023 were retrospectively analyzed,and Chi-square test was used to compare the data Qualitative parameters(gender,location,etc.) of patients in 2 groups were compared with quantitative parameters(age,artery ratio,etc.) of patients in 2 groups by t test of two independent samples.Binary logistic regression model was used to screen out independent predictors of GST and HP,and receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of CT features in differentiating GST from HP.Results Compared with patients with mesenchymal tumor,ectopic pancreas patients were more male(63.2% vs.34.1%) and younger [(37.6±10.0) years vs.(57.4±10.0)years].The tumors were more located in gastric antrum(84.4% vs.61.5%),and the enhancement was uniform and significantly enhanced.The focal components were mostly solid(89.5% vs.48.8%,53.9% vs.24.4%,94.7% vs.61.0%),the ratio of long diameter to short diameter(LD/SD ratio) was larger [(1.5±0.4) cm vs.(1.3±0.2) cm],arterial CT value was larger [(82.6±11.2) HU vs.(63.4±11.7) HU],arterial ratio and arterial enhancement rate were larger[(220.9±58.4) % vs.(186.9±49.9) %,(120.9+58.4) % vs(86.9+49.9) %],the difference had statistical significance(P <0.05).Binary logistic regression analysis showed that the independent predictors of diagnosis of GST and HP included gender,age,LD/SD ratio,and arterial enhancement rate.The optimal cut-offs of LD/SD ratio and arterial enhancement rate were 1.23 and 0.42,respectively,which could be used as reference indicators for the differentiation of the two.When combined with gender,age,long/short diameter and arterial enhancement rate,the ROC curve analysis

关 键 词：异位胰腺 间质瘤 体层摄影术 X线计算机 

分 类 号：R735[医药卫生—肿瘤] R730.44[医药卫生—临床医学]