Gastric sub-epithelial tumors: identification of gastrointestinal stromal tumors using CT with a practical scoring method
Gastric sub-epithelial tumors: identification of gastrointestinal stromal tumors using CT with a practical scoring method
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胃上皮下肿瘤：利用 CT 和实用评分方法识别胃肠道间质瘤
DOI：
10.1007/s10120-018-00908-6
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发表时间：
2019-07-01
期刊：
影响因子：
7.4
通讯作者：
Jin, Erhu
中科院分区：
文献类型：
--
作者：
Liu, Ming;Liu, Liheng;Jin, Erhu
ObjectivesTo determine CT features that can identify gastrointestinal stromal tumors（GISTs）among gastric subepithelial tumors（SETs）and to explore a practical scoring method. MethodsSix-four patients with gastric SETs（51 GISTs and 13 non-GISTs）from hospital I were included for primary analyses，and 92（67 GISTs and 25 non-GISTs）from hospital II constituted a validation cohort.回顾术前CT图像的影像学特征：病变位置、生长模式、病变边缘、增强模式、动态模式、各期图像的衰减以及是否存在坏死、浅表溃疡、钙化和病变周围肿大淋巴结（LN）。比较两组患者的临床及CT表现（GISTs与非GISTs）和GISTs风险评分方法的开发，然后，其性能识别GISTs进行了测试，在validationcohol.ResultsSeven临床和CT功能显着提示GISTs，而不是非GISTs：年龄较大（> 49岁）、病变部位不明显、边界不规则、平扫低密度（≤ 43 HU）、不均匀强化、坏死、无扩大LN（p< 0.05）。在验证阶段，建立的GIST评分方法的AUC为0.97，准确性为92%，敏感性为100%，阴性预测值（NPV）为100%。结论胃GIST具有不同于非GIST的特殊CT和临床特征。通过一种简单实用的基于显著特征的评分方法，可以准确区分GIST和非GIST。
ObjectivesTo determine CT features that can identify gastrointestinal stromal tumors (GISTs) among gastric sub-epithelial tumors (SETs) and to explore a practical scoring method.MethodsSixty-four patients with gastric SETs (51 GISTs and 13 non-GISTs) from hospital I were included for primary analyses, and 92 (67 GISTs and 25 non-GISTs) from hospital II constituted a validation cohort. Pre-operative CT images were reviewed for imaging features: lesion location, growth pattern, lesion margin, enhancement pattern, dynamic pattern, attenuation at each phasic images and presence of necrosis, superficial ulcer, calcification, and peri-lesion enlarged lymph node (LN). Clinical and CT features were compared between the two groups (GISTs versus non-GISTs) and a GIST-risk scoring method was developed; then, its performance for identifying GISTs was tested in the validation cohort.ResultsSeven clinical and CT features were significantly suggestive of GISTs rather than non-GISTs: older age (> 49 years), non-cardial location, irregular margin, lower attenuation on unenhanced images (≤ 43 HU), heterogeneous enhancement, necrosis, and absence of enlarged LN (p< 0.05). At validation step, the established scoring method with cut-off score dichotomized into ≥ 4 versus < 4 for identifying GISTs revealed an AUC of 0.97 with an accuracy of 92%, a sensitivity of 100% and a negative predictive value (NPV) of 100%.ConclusionsGastric GISTs have special CT and clinical features that differ from non-GISTs. With a simple and practical scoring method based on the significant features, GISTs can be accurately differentiated from non-GISTs.