计算机断层扫描与超声内镜对胃上皮下肿瘤诊断能力的比较研究  

Diagnostic value comparison of computed tomography and endoscopic ultrasonography in gastric subepithelial tumors

作　　者：吴益群 高腾蛟 刘超娜 WU Yiqun;GAO Tengjiao;LIU Chaona(Department of Gastroenterology,Yinzhou No.2 Hospital,Ningbo 315100,China)

机构地区：[1]宁波市鄞州区第二医院消化内科,浙江宁波315100

出　　处：《全科医学临床与教育》2024年第6期522-524,529,共4页Clinical Education of General Practice

摘　　要：目的比较计算机断层扫描(CT)与超声内镜(EUS)对胃上皮下肿瘤诊断的准确性。方法回顾性分析97例经普通白光内镜诊断胃上皮下肿瘤的患者,进行EUS和CT扫描,比较CT与EUS对胃上皮下肿瘤的诊断能力。使用受试者工作特征(ROC)曲线来计算CT可见肿瘤的最佳截点直径。真性胃上皮下肿瘤的患者接受内镜或外科手术治疗,通过与术后病理结果的对比,评价CT对真性胃上皮下肿瘤性质的诊断价值。结果在97例胃上皮下肿瘤同时行CT和EUS检查的患者中,EUS共检出73例真性胃上皮下肿瘤,24例外压隆起。73例真性胃上皮下肿瘤患者中,CT检出肿瘤32例,CT未检出41例,CT诊断的灵敏度为43.83%,特异度为100%。对CT可检出的肿瘤直径进行ROC曲线分析,认为直径大于9.85 mm的肿瘤CT更容易识别。CT和EUS对真性胃上皮下肿瘤诊断的准确率分别为46.88%及64.38%,差异无统计学意义(P>0.05)。结论CT扫描可推荐作为直径大于9.85 mm的胃上皮下肿瘤的辅助诊断、随访的方法之一。对于大于9.85 mm的胃上皮下肿瘤,CT增强扫描与EUS定性诊断的价值相似。Objective To compare the diagnostic values of computed tomography(CT)and the endoscopic ultrasonography(EUS)on gastric subepithelial tumors(SETs).Methods The 97 patients with gastric SETs were enrolled.All of the patients received CT and EUS.The diagnostic ability of CT and EUS in detecting gastric SETs was compared.Receiver operating characteristic(ROC)curve was used to calculate optimal cut-off size of tumor for predicting CT visibility of SETs.Patients with true gastric subcutaneous tumors receive endoscopic or surgical treatment,and the diagnostic value of CT in true gastric subcutaneous tumors was evaluated by comparing with postoperative pathological results.Results Of the 97 patients,73 cases of SETs and 24 cases of external compression were found.CT led to detection of 32 cases with SETs out of the 73 cases.The sensitivity and specificity of CT were 43.83% and 100%,respectively.The ROC analysis revealed that the optimal cut-off value of CT that identify the tumor visibility was 9.85 mm.The diagnostic accuracy of CT and EUS for SETs were 46.88% and 64.38%,respectively,with no significant differences(P>0.05).Conclusion CT is recommended for detection of gastric SETs,especially in tumor’s diameter larger than 9.85 mm.While CT showed the same overall accuracy with EUS.

关 键 词：胃上皮下肿瘤 计算机断层扫描 超声内镜 外压隆起 诊断能力 

分 类 号：R735.2[医药卫生—肿瘤]