计算机断层扫描血管重建术用于胃周肿块定位诊断的评估

Evaluation of computed tomography vascular reconstruction for the localization diagnosis of perigastric mass.

作者信息

Wang Ping, Zhang Cheng-Zhou, Wang Guang-Bin, Li Yang-Yang, Jiang Xing-Yue, Fang Fang-Jun, Li Xiao-Xiao, Bian Jia, Cao Xin-Shan, Zhong Xiao-Fei

机构信息

Department of Radiology, The Affiliated Hospital of Binzhou Medical University Shandong Medical Imaging Research Institute, Shandong University Department of Pathology, The Affiliated Hospital of Binzhou Medical University, Shandong, P. R. China.

出版信息

Medicine (Baltimore). 2018 Jun;97(26):e11177. doi: 10.1097/MD.0000000000011177.

DOI:10.1097/MD.0000000000011177

PMID:29952968

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6039609/

Abstract

BACKGROUND

The aim of this study was to evaluate the utility of computed tomography (CT) vascular reconstruction in the localization diagnosis of perigastric mass.

METHODS

Fifty-eight patients with pathologically detected perigastric mass underwent abdominal dynamic contrast-enhanced CT. CT vascular reconstructions were produced from arterial phase data using volume rendering (VR), multiplanar reconstruction (MPR), and maximal intensity projection (MIP). Image analysis was focused on the relationship between the mass, perigastric arteries, and the gastric wall. Localization diagnosis values were compared between CT vascular reconstruction and dynamic-enhanced CT images.

RESULTS

Among the 58 cases of perigastric mass, 41 cases originated from the stomach, 7 cases from the left liver lobe, 6 from the pancreas, 2 from lessor omental bursa, 1 from transverse mesocolon, and 1 from left adrenal gland. The accuracy of CT vascular reconstruction images in the localization diagnosis of perigastric mass was higher than that of dynamic-enhanced CT images (98.3% and 86.2%, respectively, P = .04). On the reference level, 35 (35/41) patients with stomach-originated masses showed the mass adjacent perigastric arteries pushed away from the stomach (arterial displacement sign), and 15 (15/17) patients with nonstomach-originated masses showed perigastric arteries between the mass and the stomach (arterial entrapment sign). The sensitivity, specificity, positive predictive value, and negative predictive value of the localization diagnosis of perigastric mass with arterial displacement sign were 85.4%, 100%, 100%, and 73.9%, respectively, and with arterial entrapment sign, 88.2%, 100%, 100%, and 95.3%, respectively.

CONCLUSION

CT vascular reconstruction can clearly depict the relationship between perigastric mass and adjacent perigastric arteries, which may help us more accurately differentiate between stomach-originated and nonstomach-originated masses compared with original dynamic-enhanced CT images.

摘要

背景

本研究旨在评估计算机断层扫描（CT）血管重建在胃周肿块定位诊断中的应用价值。

方法

58例经病理检测确诊为胃周肿块的患者接受了腹部动态对比增强CT检查。利用容积再现（VR）、多平面重建（MPR）和最大密度投影（MIP）技术，从动脉期数据生成CT血管重建图像。图像分析重点关注肿块、胃周动脉与胃壁之间的关系。比较CT血管重建图像与动态增强CT图像的定位诊断价值。

结果

58例胃周肿块中，41例起源于胃，7例起源于左肝叶，6例起源于胰腺，2例起源于小网膜囊，1例起源于横结肠系膜，1例起源于左肾上腺。CT血管重建图像对胃周肿块定位诊断的准确性高于动态增强CT图像（分别为98.3%和86.2%，P = 0.04）。在参考层面上，35例（35/41）胃源性肿块患者显示肿块旁胃周动脉被推离胃（动脉移位征），15例（15/17）非胃源性肿块患者显示肿块与胃之间有胃周动脉（动脉包绕征）。动脉移位征对胃周肿块定位诊断的敏感性、特异性、阳性预测值和阴性预测值分别为85.4%、100%、100%和73.9%，动脉包绕征分别为88.2%、100%、100%和95.3%。