基于计算机断层扫描的对比特征用于区分胃肠道外间质瘤与腹腔内纤维瘤病。
Computed tomography-based contrast features for distinguishing extra-gastrointestinal stromal tumors from intra-abdominal fibromatosis.
作者信息
Zhang Lijing, Li Yongbo, Luo Xinxin, Li Deqi, Yin Linlin, Li Jiayue, Zhang Li
机构信息
Cangzhou Central Hospital, Department of Radiology, Cangzhou, China.
Cangzhou Central Hospital, Department of Laboratory, Cangzhou, China.
出版信息
Diagn Interv Radiol. 2025 Jan 1;31(1):10-16. doi: 10.4274/dir.2024.242800. Epub 2024 Jul 22.
PURPOSE
This study aims to define the computed tomography (CT) criteria that distinguish extra-gastrointestinal stromal tumors (eGISTs) from intra-abdominal fibromatosis (IAF).
METHODS
Retrospective analysis was conducted on CT images obtained from 31 pathologically confirmed cases, including 17 cases of eGISTs and 14 of IAF. Various parameters [e.g., lesion location, contour characteristics, border delineation, enhancement patterns, presence of intralesional necrosis, vessels, air, fat, and hemorrhage, the long diameter (LD), LD/short diameter (SD) ratio, and volume (LD × SD × height diameter)] were meticulously evaluated. In addition, the degree of enhancement during arterial and portal venous phases and the lesion-to-aorta CT attenuation ratio during both phases were quantified. Statistical analysis was performed using Fisher's exact test, the Student's t-test, and the receiver operating characteristic curve to identify significant CT criteria. Sensitivity and specificity assessments were conducted for single and combined CT criteria.
RESULTS
Significant differentiators between eGISTs and IAF include non-mesenteric localization, irregular contour, well-defined borders, heterogeneous enhancement, presence of intralesional necrosis and vessels, and absence of intralesional fat, with LD exceeding 9.6 cm, an LD/SD ratio >1.22, and volume surpassing 603.3 cm ( < 0.05). A combination of seven or more of these criteria yielded a specificity of 100%.
CONCLUSION
Ten distinct CT criteria have been identified to distinguish eGISTs from IAF, notably encompassing non-mesenteric localization, irregular contour, well-defined borders, heterogeneous enhancement, presence of intralesional necrosis and vessels, absence of intralesional fat, LD >9.6 cm, an LD/SD ratio >1.22, and volume surpassing 603.3 cm.
CLINICAL SIGNIFICANCE
The current findings establish CT criteria to distinguish eGISTs from IAF in a clinical setting.
目的
本研究旨在确定能将胃肠道外间质瘤（eGISTs）与腹腔内纤维瘤病（IAF）区分开来的计算机断层扫描（CT）标准。
方法
对31例经病理证实的病例的CT图像进行回顾性分析，其中包括17例eGISTs和14例IAF。仔细评估了各种参数[如病变位置、轮廓特征、边界清晰度、强化模式、瘤内坏死、血管、气体、脂肪和出血的存在情况，长径（LD）、LD/短径（SD）比值以及体积（LD×SD×高径）]。此外，还对动脉期和门静脉期的强化程度以及两个时期的病变与主动脉CT衰减比值进行了量化。使用Fisher精确检验、学生t检验和受试者工作特征曲线进行统计分析，以确定显著的CT标准。对单一和联合CT标准进行了敏感性和特异性评估。
结果
eGISTs与IAF之间的显著鉴别因素包括非肠系膜定位、轮廓不规则、边界清晰、不均匀强化、瘤内坏死和血管的存在以及瘤内脂肪的缺失，LD超过9.6 cm，LD/SD比值>1.22，体积超过603.3 cm³（P<0.05）。这些标准中七个或更多标准的组合产生了100%的特异性。
结论
已确定十条不同的CT标准来区分eGISTs与IAF，特别包括非肠系膜定位、轮廓不规则、边界清晰、不均匀强化、瘤内坏死和血管的存在、瘤内脂肪的缺失、LD>9.6 cm、LD/SD比值>1.22以及体积超过603.3 cm³。
临床意义
目前的研究结果确立了在临床环境中区分eGISTs与IAF的CT标准。
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