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目的探讨多层螺旋CT(MSCT)动态增强扫描在进展期胃癌与胃间质瘤鉴别诊断中的应用价值。方法选取2013年11月至2016年12月收治的31例进展期胃癌患者为研究组,另选取同期收治的31例胃间质瘤患者为对照组。两组受检者均接受CT平扫及MSCT动态增强扫描,统计对比两组不同时期CT值与强化值、增强后最大CT值出现时期、强化程度,并分析两组MSCT动态增强扫描影像学表现。结果研究组平扫CT值、不同增强期CT值及强化值均高于对照组,差异有统计学意义(P均<0.01)。研究组最大CT值主要出现在静脉期,对照组最大CT值主要出现在平衡期,两组比较有统计学差异(P<0.01)。两组强化程度比较差异有统计学意义(P<0.01)。研究组侵犯胃浆膜面凹凸不平,周围脂肪间隙较模糊,存在结节状及条絮状软组织密度影;对照组未见浆膜面模糊,且周边无结节状软组织密度影,但肿块存在清晰边缘,向腔外生长,且局部胃壁结构受压。结论胃间质瘤与进展期胃癌MSCT动态增强扫描表现形式有明显差异,可通过其强化值、增强模式对两种疾病进行鉴别诊断。
Objective To investigate the value of multi-slice spiral CT (MSCT) dynamic contrast-enhanced scanning in the differential diagnosis of advanced gastric cancer and gastric stromal tumor. Methods 31 patients with advanced gastric cancer who were treated from November 2013 to December 2016 were selected as the study group, and 31 patients with gastric stromal tumor who were treated at the same period were selected as the control group. Two groups of subjects underwent both CT scan and MSCT dynamic contrast-enhanced scan. The CT value and enhancement value of two groups at different periods were compared statistically. The appearance and enhancement degree of maximal CT value after enhancement were compared. The dynamic imaging findings of MSCT . Results The CT value of the study group was significantly higher than that of the control group (P <0.01). The maximum CT value of the study group mainly appeared in the venous phase. The maximum CT value of the control group mainly appeared in the equilibrium period, with significant difference between the two groups (P <0.01). There was significant difference between the two groups (P <0.01). The study group invaded the gastric plasma membrane surface uneven, the surrounding fat space is more fuzzy, there nodular and soft-like flocculent cytoplasmic shadow; no serous surface in the control group, and the surrounding non-nodular soft tissue density shadow, but the existence of lumps Clear edges, grow outside the cavity, and local stomach wall structure compression. Conclusion There is a significant difference in the expression of MSCT dynamic scanning between gastric stromal tumor and advanced gastric cancer. The differential diagnosis between the two diseases can be made through the intensified mode and enhanced mode.