| 孙骏,沈力,傅剑雄,施斌斌.基于增强CT全瘤直方图分析鉴别诊断≤5 cm胃肠道间质瘤与胃神经鞘瘤[J].中国医学影像技术,2020,36(8):1211~1214 |
| 基于增强CT全瘤直方图分析鉴别诊断≤5 cm胃肠道间质瘤与胃神经鞘瘤 |
| Differential diagnosis of ≤5 cm gastric stromal tumor and gastric schwannoma with whole tumor volume histogram analysis based on enhanced CT |
| 投稿时间：2019-10-24 修订日期：2020-02-23 |
| DOI：10.13929/j.issn.1003-3289.2020.08.022 |
| 中文关键词: 胃肿瘤 诊断,鉴别 体层摄影术,X线计算机 直方图 |
| 英文关键词:stomach neoplasms diagnosis,differential tomography,X-ray computed histogram |
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| 中文摘要: |
| 目的 探讨基于增强CT全瘤直方图分析鉴别诊断最大径≤5 cm胃肠道间质瘤（GIST）与胃神经鞘瘤（GS）的价值。方法 回顾性分析在行腹部增强CT检查并经手术病理证实的最大径≤5 cm GIST患者51例和GS患者16例。以MaZda软件在包含肿瘤的每一层图像上手动勾画瘤体ROI，进行直方图分析，获得动脉期和静脉期图像的均值、变异度、偏度、峰度及第1、10、50、90、99百分位数9个参数。比较2组各参数的差异并分析参数的诊断效能。结果 动脉期直方图参数中≤5 cm GIST的均值、变异度和第1、10、50、90百分位数分别为125.71±13.57、145.31（110.44，191.84）、97.63±16.40、110.45±14.69、125.67±13.46、141.06±13.48，GS的各值分别为139.97±19.08、99.21（80.97，135.21）、113.38±19.86、127.44±18.90、140.25±19.20、152.75±20.00，2组间差异均有统计学意义（P均<0.05），ROC曲线的AUC分别为0.76、0.72、0.75、0.78、0.76和0.73。静脉期直方图参数中≤5 cm GIST变异度为144.08（106.58，221.25），GS为94.38（80.97，122.90），前者大于后者（P<0.05），AUC为0.78。结论 增强CT直方图对鉴别≤5 cm GIST与GS有较高价值，其中动脉期第10%百分位数和静脉期变异度的诊断效能较高。 |
| 英文摘要: |
| Objective To observe the value of whole tumor volume histogram analysis based enhanced CT in differential diagnosis of ≤ 5 cm gastrointestinal stromal tumor (GIST) and gastric schwannoma (GS). Methods Totally 51 patients with pathologically proven ≤ 5 cm GIST and 16 with GS underwent abdominal enhanced CT, and the images were retrospectively analyzed. ROIs were chosen at dual-phase CT images of total tumor, and histogram analysis was performed using MaZda software to obtain the mean, variation, skewness, kurtosis and percentiles (Perc.1%, Perc.10%, Perc.50%, Perc.90%, Perc.99%). The differences of the above parameters were compared between 2 groups, and their diagnostic efficacies were analyzed. Results Among histogram parameters of arterial phase images, the mean, variation and percentiles (Perc.1%, Perc.10%, Perc.50%, Perc.90%) values of GIST group were 125.71±13.57, 145.31 (110.44,191.84), 97.63±16.40, 110.45±14.69, 125.67±13.46 and 141.06±13.48, respectively, while of GS group were 139.97±19.08, 99.21 (80.97, 135.21), 113.38±19.86, 127.44±18.90, 140.25±19.20 and 152.75±20.00, respectively. There were statistical differences between 2 groups (all P<0.05), and the AUC of ROC values were 0.76, 0.72, 0.75, 0.78, 0.76 and 0.73,respectively. Among histogram parameters of venous phase images, the variation value of GIST group was 144.08 (106.58, 221.25), and of GS was 94.38 (80.97,122.90, P<0.05), and the AUC was 0.78. Conclusion Histogram analysis based enhanced CT is valuable for differentiating ≤ 5 cm GIST and GS, while Perc.10% (on arterial phase) and variation (on venous phase) have relative high diagnostic efficacy. |
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