摘要
目的:探讨双期增强CT直方图参数对胃肠道异位胰腺(Heterotopic pancreas,HP)与间质瘤(Gastrointestinal stromal tumors,GIST)的鉴别诊断价值。方法:收集经病理证实的20例胃肠道HP患者双期增强CT影像资料,并与43例大小相仿胃肠道GIST病例进行对照,分析病变部位、形态、大小及CT直方图参数(平均值、均方差、最小值、最大值、偏度、峰度、熵)的组间差异,并评估诊断效能,使用Delong检验比较各直方图参数间诊断效能差异。结果:HP与GIST组中,长径/短径(LD/SD)分别为1.51(1.34,2.02)和1.22(1.07,1.37)(z=-4.098,P<0.01);直方图特征中动脉期平均值分别为(70.31±15.79)HU和46.17(39.13,53.12)HU(z=-4.430,P<0.01),最大值为(106.89±20.50)HU和(81±20.89)HU(t=4.598,P<0.01),均方差为13.65(9.69,17.83)和11.25±2.52(z=-2.008,P=0.045);直方图特征中静脉期的平均值分别为(78.66±14.29)HU和(59.01±11.42)HU(t=5.863,P<0.01),最大值为(108.70±13.90)HU和(90.14±16.17)HU(t=4.424,P<0.01),最小值为29.50(21.00,53.50)HU和(21.88±15.24)HU(z=-2.349,P=0.019),均方差为12.66±2.79和11.16±2.45(t=2.162,P=0.035),峰度为4.77(3.38,7.43)和3.19(2.77,4.42)(z=-2.525,P=0.012),其中LD/SD、动脉期的平均值、最大值及静脉期的平均值、最大值诊断HP的AUC值分别为0.822、0.849、0.833、0.847、0.806。结论:双期增强CT直方图参数可用于鉴别HP与GIST,其中双期的平均值、最大值参数诊断效能较高。
Objective: To investi gate the diagnostic value of dual-phase contrast-enhanced CT histogram parameters in differentiating gastrointestinal heterotopic pancreas(HP) from gastrointestinal stromal tumors(GIST). Methods: Imaging data from20 patients with pathologically confirmed gastrointestinal HP, across two enhancement phases, were collected and compared with those of 43 gastrointestinal GIST cases of similar size. Parameters analyzed included lesion location, morphology, and CT histogram features(mean, standard deviation(SD), minimum, maximum, skewness, kurtosis, and entropy). Differences in these pa-rameters between the two groups were assessed for statistical significance, and their diagnostic efficacy was evaluated. The De-long test was used to compare differences in diagnostic efficacy. Differences in these parameters between the two groups were assessed for statistical significance, and their diagnostic efficacy was evaluated. Results: The LD/SD ratios in the HP and GIST groups were 1.51(1.34, 2.02) and 1.22(1.07, 1.37), respectively(z=-4.098, P<0.01). For the arterial phase, mean values were(70.31±15.79) HU and 46.17(39.13, 53.12) HU(z=-4.430, P<0.01), with maximum values at(106.89 ±20.50) HU and(81±20.89) HU(t=4.598, P<0.01) and SD at 13.65(9.69, 17.83) and 11.25±2.52(z=-2.008, P=0.045). In the venous phase, mean values were(78.66±14.29) HU and(59.01±11.42) HU(t=5.863, P<0.01), maximum values at(108.70±13.90) HU and(90.14±16.17) HU(t=4.424, P<0.01), minimum values at 29.50(21.00, 53.50) HU and(21.88±15.24) HU(z=-2.349, P=0.019), and SD at 12.66±2.79 and 11.16±2.45(t=2.162, P=0.035). Kurtosis values were 4.77(3.38, 7.43) and 3.19(2.77, 4.42) for HP and GIST, respectively(z=-2.525, P=0.012). Among these, the areas under the ROC curve(AUC) for diagnosing HP were 0.822, 0.849, 0.833,0.847, and 0.806 for the LD/SD ratio, arterial phase mean and maximum values, and venous phase mean and maximum val-ues, respectively. Conclusion: Dual-phase contrast-enhanced CT histogram analysis provides a useful tool for distinguishing HP from GIST, with mean and maximum values across both phases exhibiting high diagnostic performance.
作者
詹文博
舒艳艳
韩志江
ZHAN Wen-bo;SHU Yan-yan;HAN Zhi-jiang(Affiliated Hangzhou First People's Hospital,Westlake University School of Medicine,Hangzhou 310006,China;Xiaoshan District First People's Hospital of Hangzhou,Hangzhou 311200,China)
出处
《中国临床医学影像杂志》
北大核心
2025年第2期113-116,共4页
Journal of China Clinic Medical Imaging
