摘要
目的:探讨多层螺旋CT(MSCT)影像学特征联合全瘤不均匀度(HDT)对胃低危险度间质瘤(GIST)与胃神经鞘瘤(GS)的鉴别诊断价值。方法:回顾性分析我院经手术病理或免疫组化证实的68例GIST及21例GS患者的MSCT图像特点,分析肿瘤的一般影像征象,测量肿瘤平扫及增强后三期CT值、平扫及增强后三期HDT。绘制受试者工作特性(ROC)曲线,预测MSCT影像学特征模型、HDT模型及两者联合的诊断效能。结果:GIST组和GS组肿瘤的生长方式,周围有无增生淋巴结,动脉期、静脉期及延迟期CT值,平扫、动脉期、静脉期及延迟期HDT比较差异均有统计学意义(P<0.05)。影像学特征模型的AUC为0.847,敏感度和特异性分别为72.1%、85.7%;HDT模型的AUC为0.809,敏感度和特异性分别为92.6%、57.1%;联合诊断模型的AUC为0.884,敏感度和特异性分别为85.3%、81.0%。结论:MSCT影像学特征联合HDT建立的联合诊断模型对GIST与GS的鉴别诊断具有较高的诊断效能。
Objective:To investigate the value of multi-slice spiral CT(MSCT)imaging features combined with whole tumor inhomogeneity(HDT)in the differential diagnosis of gastric low risk stromal tumor(GIST)and gastric schwannoma(GS).Methods:The MSCT image features of 68 patients with GIST and 21 patients with GS confirmed by pathology or immunohistochemistry were retrospectively analyzed.The general imaging signs of the tumors were analyzed.The CT value and HDT after MSCT plain scan and three-phase enhanced scan were measured.The receiver operating characteristic(ROC)curve was drawn to predict the diagnostic efficacy of MSCT imaging feature model,HDT model and their combination.Results:There were significant differences between GIST group and GS group in tumor growth pattern,peripheral lymph node proliferation,CT value in arterial phase,venous phase and delayed phase,and HDT in plain scan phase,arterial phase,venous phase and delayed phase(P<0.05).The AUC of image feature model was 0.847,the sensitivity and specificity were 72.1%and 85.7%respectively.The AUC of HDT model was 0.809,the sensitivity and specificity were 92.6%and 57.1%,respectively.The AUC of the combined diagnostic model was 0.884,the sensitivity and specificity were 85.3%and 81.0%,respectively.Conclusion:The combined diagnostic model established by MSCT imaging features combined with HDT has high diagnostic efficiency for the differential diagnosis of GIST and GS.
作者
吴树剑
翟建
范莉芳
WU Shujian;ZHAI Jian;FAN Lifang(Medical Imaging Center,Yijishan Hospital,Wannan Medical College,Wuhu 241001,China)
出处
《沈阳医学院学报》
2022年第4期370-373,共4页
Journal of Shenyang Medical College
基金
皖南医学院中青年科研基金(No.WK202003)
皖南医学院教学质量与教学改革工程(No.2020jyxm43)。
关键词
MSCT
不均匀度
胃低危险度间质瘤
胃神经鞘瘤
鉴别诊断
MSCT
inhomogeneity
gastric low risk stromal tumor
gastric schwannoma
differential diagnosis
