Weng J W, Wang J, Li F, Xu J L, Hu H J
Department of Medical Imaging, School Hospital, Zhejiang University, Hangzhou, 310027, China.
Department of Radiology, Jianggan District People's Hospital, Hangzhou 310021, China.
Zhonghua Zhong Liu Za Zhi. 2017 Feb 23;39(2):139-144. doi: 10.3760/cma.j.issn.0253-3766.2017.02.013.
To explore the application value of CT imaging in differentiating gastric stromal tumors (GST) from gastric leiomyomas (GLMs). CT images of patients with GST (=65) or GLMs (=13, maximum diameter of tumor ≤5 cm) proved by surgery and pathology were retrospectively analyzed. The tumor size, location, contour, growth pattern, degree and pattern of enhancement, calcification, necrosis, surface ulceration, lymph nodes, and patient clinical data were evaluated by two independent reviewers. Receiver operating characteristic (ROC) curves were employed to assess the measurement and calculation parameters in the differentiation of GST and GLMs. Between the GST and GLMs groups, there was no statistically significant difference in the contour, growth pattern, calcification, surface ulceration, and patient's sex (>0.05). CT values of in plain scans, degree of enhancement in arterial phase (DE1), size, location and pattern of enhancement were found to be different between GST and GLMs (<0.05). When the cutoff value of the maximum tumor diameter was 3.2 cm, the area under ROC curve, sensitivity and specificity were 0.707, 92.3%(12/13) and 60.6%(40/66), respectively. When the cutoff value of age was 59 years, the area under ROC curve, sensitivity and specificity were 0.773, 92.3% (12/13) and 46.2% (30/65), respectively. Taking the cutoff value of 10.9 HU as the degree of enhancement in arterial phase (DE1), the area under ROC curve, sensitivity and specificity were 0.774, 84.6% (11/13) and 77.3% (51/66), respectively. Using a cutoff value of 30.3 HU, the sensitivity, specificity, and the area under ROC curve were 84.6% (11/13), 65.2% (43/66), and 0.731, respectively. CT examination in addition to clinical data can be very helpful for the differential diagnosis of GLMs from GSTs in maximum diameter ≤5 cm.
探讨CT成像在鉴别胃间质瘤（GST）与胃平滑肌瘤（GLM）中的应用价值。回顾性分析经手术及病理证实的GST患者（n = 65）或GLM患者（n = 13，肿瘤最大直径≤5 cm）的CT图像。由两名独立阅片者评估肿瘤大小、位置、轮廓、生长方式、强化程度及方式、钙化、坏死、表面溃疡、淋巴结情况以及患者临床资料。采用受试者操作特征（ROC）曲线评估GST与GLM鉴别中的测量及计算参数。GST组与GLM组在轮廓、生长方式、钙化、表面溃疡及患者性别方面差异无统计学意义（>0.05）。GST与GLM在平扫CT值、动脉期强化程度（DE1）、大小、位置及强化方式方面存在差异（<0.05）。当肿瘤最大直径的截断值为3.2 cm时，ROC曲线下面积、敏感度及特异度分别为0.707、92.3%（12/13）及60.6%（40/66）。当年龄截断值为59岁时，ROC曲线下面积、敏感度及特异度分别为0.773、92.3%（12/13）及46.2%（30/65）。以动脉期强化程度（DE1）10.9 HU为截断值时，ROC曲线下面积、敏感度及特异度分别为0.774、84.6%（11/13）及77.3%（51/66）。以30.3 HU为截断值时，敏感度、特异度及ROC曲线下面积分别为84.6%（11/13）、65.2%（43/66）及0.731。除临床资料外CT检查对最大直径≤5 cm的GLM与GST的鉴别诊断很有帮助。
