MSCT平扫、增强扫描在诊断胃神经鞘瘤中临床价值

目的探讨多层螺旋CT(MSCT)平扫、增强扫描在诊断胃神经鞘瘤中的临床价值。方法选取2013年1月至2016年10月我院收治的胃神经鞘瘤患者20例为研究对象,回顾性分析胃神经鞘瘤的MSCT平扫、增强扫描表现,包括病变部位、肿瘤大小、强化特点及与黏膜接触面溃疡等情况,比较MSCT平扫与增强扫描的肿瘤直径、CT值及诊断效能,同时分析胃神经鞘瘤的鉴别诊断点。结果胃神经鞘瘤的MSCT平扫表现为胃壁起源的圆形或类圆形肿块,单发,边界清晰,质地均匀,病灶均见不同程度内部囊变,MSCT增强扫描呈渐进性持续性强化,囊变区不强化,动脉期轻度强化,门脉期中度强化,实质期强化明显;MSCT增强扫描动脉期、门脉期、实质期的肿瘤直径(4.12±0.23)cm、(5.06±0.08)cm、(5.11±0.02)cm]、CT值(53.26±1.06)、(70.15±0.14)、(7 0.1 6±0.3 2)]均较MSCT平扫高(P0.05);MSCT增强扫描诊断胃神经鞘瘤的准确度95.00%明显高于MSCT平扫72.22%(P0.05),而灵敏度、特异度比较无显著差异(P0.05);胃神经鞘瘤的形态、增强后强化程度、是否发生腹膜后淋巴结肿大/转移等可作为与胃间质瘤、胃淋巴瘤等胃部肿瘤的鉴别诊断点。结论MSCT可准确显示胃神经鞘瘤的形态、部位及内部结构与邻近结构的关系,通过增强扫描可提高诊断准确度,有利于作出正确诊断。

MSCT Scan and Enhanced Scan in the Diagnosis of Gastric Schwannoma Clinical Value

Objective to evaluate multislice CT (MSCT) scan and enhanced scan in the diagnosis of gastric schwannoma clinical value.Methods Selection methods from January 2013 to October 2013 of our hospital 20 patients with gastric schwannoma as the research object,a retrospective analysis of gastric schwannoma MSCT scan and enhanced scan performance,including the lesion site,tumor size,strengthening the characteristics and the mucous membrane contact surface ulcers,etc.,to compare tumor diameter of MSCT scan and enhanced scan,CT value and diagnostic efficiency,at the same time analysis the differential diagnosis of gastric schwannoma.Results MSCT scan of gastric schwannoma is the origin of the stomach wall round or class round mass,single,clear boundary,uniform texture,see lesions are different degree of internal capsule,progressive persistent strengthening MSCT enhanced scan,the areas of capsule of not reinforced,mild arterial enhancement and portal phase moderately strengthening,substantial improved significantly;MSCT enhanced scanning stage arterial,portal,the essence of the tumor diameter (4.12+0.23) cm,(5.06-0.08) cm,(5.11-0.02) cm],CT value (53.26+1.06),(70.15-0.14),(70.16-0.32)] are higher than MSCT scan (P＜0.05).The accuracy of MSCT enhanced scan in the diagnosis of gastric schwannoma significantly higher than the 95.00％ 72.22％ MSCT scan (P＜0.05),and sensitivity,specific degrees is no significant difference (P＞0.05).The morphology of gastric schwannoma,increase after strengthening degree,whether in retroperitoneal lymph node enlargement/transfer can serve as a gastric stromal tumors and gastric lymphoma the differential diagnosis of gastric cancer.Conclsion MSCT can accurately show the morphology of gastric schwannoma;parts,and the relationship between internal structure and adjacent structure,through enhanced scan can improve the diagnostic accuracy,is helpful to make correct diagnosis.