CT特征对鉴别基于倾向性得分匹配的胃平滑肌瘤和胃间质瘤的价值  

Value of CT features in differentiating gastric leiomyomas and gastric stromal tumors based on propensity score matching

作　　者：王丽佳[1] 齐晓辉[1] 潘江洋[1] 谢巧 杨丽[1] 王琦[1] WANG Lijia;QI Xiaohui;PAN Jiangyang;XIE Qiao;YANG Li;WANG Qi(Department of CT&MRI,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院CT&MRI科,河北石家庄050011

出　　处：《实用放射学杂志》2024年第5期741-745,共5页Journal of Practical Radiology

摘　　要：目的评价倾向性得分匹配后胃平滑肌瘤(GLs)和胃间质瘤(GSTs)的CT特征及鉴别价值。方法26例GLs患者根据性别、年龄、肿瘤部位、大小与GSTs进行1︰1倾向性得分匹配。分析肿瘤形状、轮廓、黏膜溃疡、肿瘤生长方式、强化方式和程度、肿瘤长径(LD)、LD与垂直直径(VD)比值。CT征象包括出血、钙化、外周浸润、远处转移等,应用回归分析确定2种肿瘤鉴别的最佳定量评价。结果GSTs患者出现黏膜溃疡的发生率明显高于GLs患者(P=0.032)。进行性强化是2种肿瘤的共同特征;而在动脉期和门静脉期,GSTs的强化程度均显著高于GLs(P=0.004,P=0.002)。将上述影响因素纳入回归分析以动脉期强化程度18HU、门静脉期强化程度23HU作为临界值,动脉期强化程度≤18HU被认为是诊断GLs的独立影响因素[比值比(OR)=12.776,95%置信区间(CI)1.270~128.535]。肿瘤的LD/VD比值、肿瘤异质性、生长方式等形态学特征均无明显差异(P>0.05)。结论肿瘤表面少伴发溃疡,动脉期的轻度强化是GLs区别于GSTs的特征性表现。Objective To evaluate the CT features and differential value of gastric leiomyomas(GLs)and gastric stromal tumors(GSTs)after propensity score matching.Methods Twenty-six GLs were 1:1 propensity score matched to GSTs based on sex,age,tumor site and size.Tumor shape and contour,mucosal ulcer,tumor growth patterns,enhancement pattern and degree,the longest diameter(LD)of the tumor,and the ratio of the LD to the vertical diameter(VD)were analyzed.CT signs included hemorrhage,calcification,peripheral invasion,and distant metastasis,etc.Regression analysis was used to determine the best quantitative evaluation for differentiation of them.Results The presence of mucosal ulcer was significantly more frequent in GSTs than in GLs(P=0.032).Both tumors showed progressive enhancement;however,the enhancement degree of GSTs was significantly higher than GLs in the arterial and portal venous phases(P=0.004,P=0.002,respectively).The above influential factors were included in a regression analysis using enhancement degree of 18 HU and 23 HU in the arterial and portal venous phases as cutoff values respectively.An enhancement degree<18 HU in the arterial phase was identified as an independent influential factor in the diagnosis of GLs[odds ratio(OR)=12.776,95%confidence interval(CI)1.270-128.535].No significant difference was found in other morphological characteristics(P>0.05).Conclusion Less ulceration on the tumor surface and mild enhancement in arterial phase are characteristic features of GLs compared with GSTs.

关 键 词：胃间质瘤 胃平滑肌瘤 计算机体层成像 倾向性得分匹配 

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