CAJ | 학술논문

目的：分析胃间质瘤（GST）的宝石 CT 能谱表现，探讨宝石 CT 能谱对其诊断与鉴别诊断的应用价值。资料与方法回顾性分析30例经手术病理证实并行宝石 CT 能谱成像扫描的 GST 患者的影像资料及相关临床资料，并通过测定病灶动脉期、静脉期的碘含量进行定量分析。结果 GST 的 CT 能谱表现为软组织肿块，病灶大小不一，向胃腔内或外或同时向腔内外突出，其中低危组肿瘤直径1~5 cm 4例；中危组肿瘤直径1~5 cm 3例，6~19 cm 3例；高危组肿瘤直径6~9 cm 18例，1~5 cm 2例，1例患者为大小不等的多发病灶。肿瘤发生在胃体部15例，胃窦部10例，胃底部4例，多灶性多部位生长1例。肿瘤腔内外生长16例，其中高危患者14例；腔外生长10例，其中高危患者6例，低危患者1例；腔内生长4例，其中低危患者3例。动脉期病灶轻度强化，静脉期病灶强化程度增加，病灶与正常胃壁动脉期及静脉期的碘含量及标准碘含量差异有统计学意义（F=378.6、296.6，P<0.05）。病灶动脉期及静脉期能谱曲线斜率差异有统计学意义（t=－2.245，P<0.05）。结论宝石 CT 能谱成像可以准确显示 GST 病灶的外部形态、内部改变，通过测定碘含量可提供肿瘤定量诊断信息，能够为临床提供更多有效的信息和依据。
목적：분석위간질류（GST）적보석 CT 능보표현，탐토보석 CT 능보대기진단여감별진단적응용개치。자료여방법회고성분석30례경수술병리증실병행보석 CT 능보성상소묘적 GST 환자적영상자료급상관림상자료，병통과측정병조동맥기、정맥기적전함량진행정량분석。결과 GST 적 CT 능보표현위연조직종괴，병조대소불일，향위강내혹외혹동시향강내외돌출，기중저위조종류직경1~5 cm 4례；중위조종류직경1~5 cm 3례，6~19 cm 3례；고위조종류직경6~9 cm 18례，1~5 cm 2례，1례환자위대소불등적다발병조。종류발생재위체부15례，위두부10례，위저부4례，다조성다부위생장1례。종류강내외생장16례，기중고위환자14례；강외생장10례，기중고위환자6례，저위환자1례；강내생장4례，기중저위환자3례。동맥기병조경도강화，정맥기병조강화정도증가，병조여정상위벽동맥기급정맥기적전함량급표준전함량차이유통계학의의（F=378.6、296.6，P<0.05）。병조동맥기급정맥기능보곡선사솔차이유통계학의의（t=－2.245，P<0.05）。결론보석 CT 능보성상가이준학현시 GST 병조적외부형태、내부개변，통과측정전함량가제공종류정량진단신식，능구위림상제공경다유효적신식화의거。
Purpose To investigate the CT gemstone spectral imaging features of gastric stromal tumors (GST), so as to discuss the value of CT gemstone spectral imaging in the diagnosis and differential diagnosis of GST. Materials and Methods Thirty patients with GST proved pathologically were scanned by gemstone spectral imaging. Their GSI scanning image data and the related clinical data were retrospectively analyzed, and the quantitative analysis based on iodine content of the lesions in both arterial phase and portal phase was carried out. Results The GSI findings showed that the lesions were intra-luminal, extra-luminal or both intra-and extra-luminal soft tissue mass, the sizes were various, and they protruded either toward the inner side of stomach or the opposite or both. Among them, the diameter of 4 tumors in the low risk group ranged from 1 to 5 cm; in the intermediate risk group, 3 tumors had diameters from 1 to 5 cm, and 3 others were from 6 to 19 cm; in high-risk group, 18 tumors' diameter were between 6 to 9 cm, 2 were between 1 to 5 cm, and the rest 1 had multiple lesions in various sizes. Fifteen tumors occurred in gastric body, 10 occurred in gastric antrum, 4 were at the bottom of the stomach, and 1 had multifocal growth. Sixteen patients had internal and external growth of lesions, among whom 14 patients were at high risk; 10 patients' lesions were outside the cavity, including 6 patients at high risk and 1 patient at low risk; and 4 patients had lesions inside the cavity, including 3 patients at low risk. At the arterial phase the foci mildly strengthened, and they strengthened increasingly at the portal phase. The material value based water and iodine figure showed that material value based iodine of the lesions at both arterial phase and portal phase was higher than that in the normal gastric wall tissue, and the material value based iodine of the lesions at portal phase was higher than that at arterial phase (F=378.6 and 296.6, P<0.05). At arterial phase, the iodine content of the lesions in the mucosa was slightly higher than that in the submucosa and muscular layer (t= - 2.245, P<0.05). Conclusion CT gemstone spectral imaging can accurately show the external forms and internal changes of GST lesions and iodine content measurement can provide quantitative diagnostic information, therefore they can provide more effective information for clinical diagnosis.