CT 鉴别胃异位胰腺与胃间质瘤。
CT differentiation of gastric ectopic pancreas from gastric stromal tumor.
机构信息
Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, P. R. China.
Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, China.
出版信息
BMC Gastroenterol. 2021 Feb 4;21(1):52. doi: 10.1186/s12876-021-01617-8.
BACKGROUND
Gastric ectopic pancreas (GEPs) is a rare developmental anomaly which is difficult to differentiate it from submucosal tumor such as gastric stromal tumor (GST) by imaging methods. Since the treatments of the GEPs and GST are totally different, a correct diagnosis is essential. Therefore, we retrospectively investigated the CT features of them to help us deepen the understanding of GEPs and GST.
METHODS
This study enrolled 17 GEPs and 119 GST, which were proven pathologically. We assessed clinical and CT features to identify significant differential features of GEPs from GST using univariate and multivariate analyses.
RESULTS
In univariate analysis, among all clinicoradiologic features, features of age, symptom, tumor marker, location, contour, peritumoral infiltration or fat-line of peritumor, necrosis, calcification, CT attenuation value of unenhancement phase/arterial phase/portal venous phase (CTu/CTa/CTp), the CT attenuation value of arterial phase/portal venous phase minus that of unenhanced phase (DEAP/DEPP), long diameter (LD), short diameter (SD) were considered statistically significant for the differentiation of them. And the multivariate analysis revealed that location, peritumoral infiltration or fat-line of peritumor, necrosis and DEPP were independent factors affecting the identification of them. In addition, ROC analysis showed that the test efficiency of CTp was perfect (AUC = 0.900).
CONCLUSION
Location, the presence of peritumoral infiltration or fat-line of peritumor, necrosis and DEPP are useful CT differentiators of GEPs from GST. In addition, the test efficiency of CTp in differentiating them was perfect (AUC = 0.900).
背景
胃异位胰腺（GEP）是一种罕见的发育异常，通过影像学方法难以将其与黏膜下肿瘤（如胃间质瘤[GST]）相区分。由于 GEP 和 GST 的治疗方法完全不同，因此正确的诊断至关重要。因此，我们回顾性研究了它们的 CT 特征，以帮助我们加深对 GEP 和 GST 的认识。
方法
本研究纳入了 17 例 GEP 和 119 例 GST，这些病变均经病理证实。我们评估了临床和 CT 特征，通过单变量和多变量分析来确定 GEP 与 GST 的显著鉴别特征。
结果
在单变量分析中，在所有临床影像学特征中，年龄、症状、肿瘤标志物、位置、轮廓、肿瘤周围浸润或肿瘤周围脂肪线、坏死、钙化、平扫期/动脉期/门静脉期 CT 值（CTu/CTa/CTp）、动脉期/门静脉期 CT 值与平扫期 CT 值差值（DEAP/DEPP）、长径（LD）、短径（SD）等特征被认为对鉴别两者具有统计学意义。多变量分析显示，位置、肿瘤周围浸润或肿瘤周围脂肪线、坏死和 DEPP 是影响两者鉴别的独立因素。此外，ROC 分析显示 CTp 的检测效能为完美（AUC=0.900）。
结论
位置、肿瘤周围浸润或肿瘤周围脂肪线、坏死和 DEPP 是鉴别 GEP 和 GST 的有用 CT 特征。此外，CTp 在鉴别两者方面的检测效能为完美（AUC=0.900）。
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