鲁达 杨金生

[摘要] 目的 探討64排螺旋CT在胃间质瘤诊断中的价值。 方法 选取2017年5月至2020年3月我院收治的38例经手术确诊的胃间质瘤患者作为研究对象，术前均行64排CT及MRI平扫和动态增强检查，对患者的临床及影像学资料等进行收集汇总，综合分析胃间质瘤的CT表现特征，并与MRI图像进行对比，评估64排CT对胃间质瘤的检出率及准确诊断的符合率。 结果 64排螺旋CT在诊断胃间质瘤的敏感度为94.11%，特异度为75.00%，准确率92.10%，阳性预测值96.96%，阴性预测值60.00%。MRI在诊断胃间质瘤的敏感度为97.14%，特异度为66.67%，准确率94.73%，阳性预测值97.14%，阴性预测值66.67%。CT与MRI在胃间质瘤的病变诊断上具有高度的一致性，差异无统计学意义（P>0.05）。 结论 64排螺旋CT可清晰显示胃间质瘤的病灶特征，且无创性，对胃间质瘤的检出率及诊断准确率具有较高的临床价值，可作为胃间质瘤诊断的主要筛查手段。

[关键词] 64排螺旋CT;胃间质瘤;鉴别诊断;MRI

[中图分类号] R445          [文献标识码] B          [文章编号] 1673-9701（2021）35-0126-04

Investigation on the value of 64-slice spiral CT scan in the diagnosis of gastric stromal tumors

LU Da   YANG Jinsheng

Department of Radiology，Shenyang Traditional Chinese Medicine Hospital， Shenyang   110003，China

[Abstract] Objective To investigate the value of 64-slice spiral CT scan in the diagnosis of gastric stromal tumors. Methods A total of 38 patients with gastric stromal tumors admitted to our hospital from May 2017 to March 2020 were selected as the study objects. All patients underwent 64-slice CT and MRI plain scan and dynamic contrast-enhanced examination before operation. The clinical and imaging data of the patients were collected and summarized. The CT features of gastric stromal tumors were comprehensively analyzed and compared with MRI images to evaluate the detection rate of gastric stromal tumors and the coincidence rate of accurate diagnosis. Results The sensitivity of 64-slice spiral CT in the diagnosis of gastric stromal tumors was 94.11%， the specificity was 75.00%，the accuracy was 92.10%， the positive predictive value was 96.96%， and the negative predictive value was 60.00%. The sensitivity of MRI in the diagnosis of gastric stromal tumors was 97.14%， the specificity was 66.67%， the accuracy was 94.73%， the positive predictive value was 97.14%， and the negative predictive value was 66.67%. CT and MRI were highly consistent in the pathological diagnosis of gastric stromal tumors， without statistically significant difference（P>0.05）. Conclusion 64-slice spiral CT can clearly show the focus features of gastric stromal tumors，and it is non-invasive. It has relatively high clinical value for the detection rate and diagnostic accuracy of gastric stromal tumors. Therefore， it can be used as the main screening method for the diagnosis of gastric stromal tumors.

[Key words] 64-slice spiral CT; Gastric stromal tumor; Differential diagnosis; MRI

胃间质瘤是原发于胃肠道壁的间叶性肿瘤，是消化道最常见的肿瘤，可以发生在消化道的任何部位，以胃部居多，由于胃肠道间质瘤的临床症状无明显的特异性，单纯依靠临床的症状等进行诊断比较困难，且胃间质瘤具有潜在的恶变可能，一旦出现恶变，出现转移的概率非常高，因此早期对胃间质瘤的检出和诊断有助于早期治疗和干预，提高患者的生存率和生活质量有极其重要的意义。近些年生活节奏的增快，压力的增大，胃间质瘤的发病率有……