摘要
目的:分析多层螺旋CT(MSCT)检查对胃间质瘤(GIST)的鉴别诊断效能,并分析CT相关参数值.方法:选取2020年12月—2023 年 12 月枣庄市台儿庄区中医院收治的 79 例疑似GIST患者为研究对象,入院时均接受MSCT检查,并以择期进行的穿刺活检或手术病理检查结果为依据,分析MSCT检查对GIST的鉴别诊断效能;比较不同危险分级GIST患者CT参数差异[平扫CT值(CTu)、动脉期CT值(CTa)、静脉期CT值(CTp)、延迟期CT值(CTd)、动脉增强分数(AEF)].结果:79例疑似GIST患者病理检查结果显示,64例确诊为GIST,其中极低危、低危、中危、高危患者分别为11例、14例、18例、21例;以病理检查结果作为依据,MSCT检查GIST的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为93.75%、86.67%、92.41%、96.77%、76.47%,一致性良好(Kappa值=0.765).不同危险分级GIST患者CTu、CTa及AEF比较,差异有统计学意义(P＜0.05);不同危险分级GIST患者CTp、CTd比较,差异无统计学意义(P＞0.05).结论:MSCT检查鉴别诊断GIST的灵敏度、特异度及准确率均较高,与病理检查结果一致性极好,且不同危险度GIST患者CT参数中的CTu、CTa及AEF存在差异.
Abstract
Objective To analyze the differential diagnosis efficiency of multi-slice spiral CT(MSCT)in gastrointestinal stromal tumor(GIST),and the related parameters of CT were analyzed.Methods A total of 79 suspected GIST patients admitted to Taierzhuang District Hospital of Traditional Chinese Medicine in Zaozhuang City from December 2020 to December 2023 were selected.All of them received MSCT examination on admission,and based on the results of elective puncture biopsy or surgical pathology,the differential diagnosis efficacy of MSCT examination in GIST was analyzed.Comparison of CT parameters of GIST patients with different risk grades[plain CT value(CTu),arterial CT value(CTa),venous CT value(CTp),delayed CT value(CTd)and arterial enhancement fraction(AEF)].Results Pathological examination results of 79 suspected GIST patients showed that 64 cases were confirmed as GIST,including 11 cases of very low risk,14 cases of low risk,18 cases of medium risk and 21 cases of high risk.Based on pathological examination results,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MSCT were 93.75%,86.67%,92.41%,96.77%and 76.47%,respectively.The agreement is good(Kappa=0.765).There were significant differences in CTu,CTa and AEF parameters among GIST patients with different risk grades(P<0.05).There was no significant difference in the CTp and CTd parameters of GIST patients with different risk grades(P>0.05).Conclusion The sensitivity,specificity and accuracy of MSCT in differential diagnosis of GIST are high,which is in good agreement with pathological results,and there are differences in CTu,CTa and AEF of CT parameters in patients with different risk of GIST.
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