He Mingyan, Zhang Rong, Zhai Fengyi, Zhou Lisha, Wang Meng, Jiang Mengjie, Li Ziping, Feng Shiting
Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510086, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2015 Oct;18(10):1020-5.
To compare the CT image of gastrointestinal schwannomas (GIS) and gastrointestinal stromal tumors(GIST), and to find the CT features to be helpful for differentiation of GIS from GIST.
Clinical and iconography data of 15 GIS patients and 50 GIST patients who underwent stomach CT scan with postoperatively confirmed histopathology between January 2000 and July 2014 in our department were collected retrospectively. CT findings of these two tumors were compared. Then the ROC curve was drawn based on the significant CT findings and area under the curve (AUC) was calculated to assess the sensibility and specificity for the differential diagnosis of GIS and GIST.
CT findings, such as the tumor size, shape, cystic change, perilesional lymph nodes, vessel seeding, enhancement pattern and degree, absolute and standardized CT value were significantly different between GIS and GIST(all P<0.05). Among the CT findings, tumor size, cystic change, perilesional lymph nodes, enhancement pattern and arterial phase standardized CT value (Sa) were better differential than others (all AUC>0.7). Tumor size showed the highest sensibility(90%), and cystic change and Sa showed the highest specificity(87%).
GIS seems to show a homogeneous tumor more frequently, presenting light and moderate enhancement pattern and obvious enhancement of perilesional lymph nodes, while GIST seems to reveal malignant features, such as abundant blood supply, larger volume, frequent necrosis and cystic change. Cystic change and Sa value possess the better differential ability in diagnosis of these two tumors.
比较胃肠道神经鞘瘤(GIS)与胃肠道间质瘤(GIST)的CT图像,寻找有助于鉴别GIS和GIST的CT特征。
回顾性收集2000年1月至2014年7月在我科接受胃部CT扫描且术后病理确诊的15例GIS患者和50例GIST患者的临床及影像学资料。比较这两种肿瘤的CT表现。然后根据有意义的CT表现绘制ROC曲线并计算曲线下面积(AUC),以评估鉴别诊断GIS和GIST的敏感性和特异性。
GIS和GIST在肿瘤大小、形态、囊性变、瘤周淋巴结、血管播散、强化方式及程度、绝对CT值和标准化CT值等CT表现上有显著差异(均P<0.05)。在CT表现中,肿瘤大小、囊性变、瘤周淋巴结、强化方式和动脉期标准化CT值(Sa)的鉴别能力优于其他指标(均AUC>0.7)。肿瘤大小的敏感性最高(90%),囊性变和Sa的特异性最高(87%)。
GIS似乎更常表现为均匀性肿瘤,呈轻、中度强化方式,瘤周淋巴结明显强化,而GIST似乎表现出恶性特征,如血供丰富、体积较大、频繁坏死和囊性变。囊性变和Sa值在诊断这两种肿瘤时具有较好的鉴别能力。