Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China.
Department of Radiology, Sir Run Run Shaw Hospital, 12377Zhejiang University, Hangzhou, Zhejiang, China.
Can Assoc Radiol J. 2021 Aug;72(3):444-451. doi: 10.1177/0846537119885671. Epub 2020 Feb 28.
To discuss significant computed tomography (CT) findings that differentiate gastric leiomyomas (GLs) from small gastric stromal tumors (GSTs).
One hundred sixty cases with pathologically proven GLs (n = 50) and GSTs (n = 110) with comprehensive CT images were enrolled in this retrospective study. Computed tomography findings (ie, size, location, contour, growth pattern, enhancement degree, necrosis, ulceration, calcification, and lymph nodes) were analyzed through the χ or Fisher exact test, independent test, and multivariate (logistic regression) analysis. Sensitivity and specificity were also calculated.
Features of cardia location, endophytic growth, homogeneous gradual enhancement, absent of necrosis, long diameter less than 24 mm, short diameter less than 20 mm, unenhanced CT value larger than 35.2 Hounsfield units (HU), portal venous phase CT value larger than 67.4 HU, and enhancement degree of arterial and venous phase less than 16.2 HU and 32.4 HU were found to be statistically significant between GLs and small GSTs ( .05). On multivariate analysis, cardia location, endophytic growth, and homogeneous gradual enhancement were independent predictive factors for GLs and small GSTs.
These 10 CT criteria are very helpful to differentiate GLs from small GSTs. Especially cardia location, endophytic growth, and homogeneous gradual enhancement are of high value in differential diagnosis.
讨论有助于区分胃平滑肌瘤（GL）和胃小间质瘤（GST）的有意义的计算机断层扫描（CT）表现。
本回顾性研究纳入了 160 例经病理证实的 GL（n=50）和 GST（n=110）患者，均有完整的 CT 图像。通过卡方或 Fisher 确切检验、独立 t 检验和多变量（logistic 回归）分析，分析 CT 表现（即大小、位置、轮廓、生长方式、强化程度、坏死、溃疡、钙化和淋巴结）。还计算了灵敏度和特异性。
心侧位置、内生性生长、均匀渐进性强化、无坏死、长径小于 24mm、短径小于 20mm、平扫 CT 值大于 35.2 亨氏单位（HU）、门静脉期 CT 值大于 67.4HU、动脉期和门静脉期强化程度小于 16.2HU 和 32.4HU 是 GL 和小 GST 之间有统计学意义的特征（P＜0.05）。多变量分析显示，心侧位置、内生性生长和均匀渐进性强化是 GL 和小 GST 的独立预测因素。
这 10 项 CT 标准对于区分 GL 和小 GST 非常有帮助。特别是心侧位置、内生性生长和均匀渐进性强化在鉴别诊断中有很高的价值。
