•临床经验CLINICALPRACTICE•良恶性胃壁增厚的CT鉴别戴洪修,谷家林,鲁际,周建雄,刘卫红,肖治明,李海涛戴洪修,三峡大学第一临床医学院湖北省宜昌市中心人民医院湖北省宜昌市443003谷家林,湖北省当阳市人民医院湖北省宜昌市443003鲁际,周建雄,刘卫红,肖治明,李海涛,湖北省宜昌市中心人民医院湖北省宜昌市443003通讯作者:戴洪修,443003,湖北省宜昌市夷陵路127号,湖北省宜昌市中心人民医院.daihongxiu222@yahoo.com.cn电话:0717-6458315收稿日期:2005-10-14接受日期:2005-11-16ComputedtomographydifferentiationofbenignandmalignantgastricwallthicknessHong-XiuDai,Jia-LinGu,JieLu,Jian-XiongZhou,Wei-HongLiu,Zhi-MingXiao,Hai-TaoLiHong-XiuDai,theFirstCollegeofClinicalMedicalScienceofSanxiaUniversity;YichangCentralPeople’sHospital,Yichang443003,HubeiProvince,ChinaJia-LinGu,DangyangPeople’sHospital,Dangyang443003,HubeiProvince,ChinaJieLu,Jian-XiongZhou,Wei-HongLiu,Zhi-MingXiao,Hai-TaoLi,YichangCentralPeople’sHospital,Yichang443003,HubeiProvince,ChinaCorrespondenceto:Hong-XiuDai,YichangCentralPeople’sHospital,127YilingRoad,Yichang443003,HubeiProvince,China.daihongxiu222@yahoo.com.cnReceived:2005-10-14Accepted:2005-11-16AbstractAIM:Todeterminethesensitivityandspecificityofthecomputedtomography(CT)fordifferentiatingbenignandmalignantthicknessofthegastricwall.METHODS:Thedatawerecollectedfrom40patientswithgastricwallthicknessdeterminedbyspiralCTex-amination,whounderwentbariummealexaminationwithin4wkbeforeoraftertheCTexamination.TheCTimageswerereviewedtodeterminethedegreeofthegastricwallthickenessandthesymmetry,distribution,andenhancementofthethickenedwall.ThesensitivityandspecificityofCTindetectingthemalignanttumorwerecalculatedthroughtheabovefeatures.RESULTS:Ofthe40cases,20werewithgastritis,4withhiatalhernia,3withbenignulcer,3withbe-nigngastricneoplasm,8withmalignantneoplasm,and2withnoabnormality.Themeanthicknessofthegastricwallwas14mm(7-65mm).Allthegas-tricwallswiththickness≥10mmwerediagnosedasmalignancybyCT,andthesensitivityratewas100%,butthespecificityratewas43%.Thesensi-tivityrateforfocal,eccentric,andenhancedgastricwallthicknesswas93%,71%,and43%,andthespecificityratewas8%,75%,and88%,respective-ly.Generally,thesensitivityfordetecting10mm-ormorethan10mm-thickgastricwalls,whichwerefocal,eccentric,andenhanced,was36%,butthespecificitywas93%.CONCLUSION:Afteracomprehensiveconsidera-tionoffocal,eccentric,andenhancingthickness,thespecificityrateofCTcanbegreatlyincreased,sofurtherexaminationshouldbeperformedinthenearfuture.KeyWords:Gastrointestinaltract;Bariummealexami-nation;Stomach;ComputedTomography;NeoplasmDaiHX,GuJL,LuJ,ZhouJX,LiuWH,XiaoZM,LiHT.Computedtomographydifferentiationofbenignandmalignantgastricwallthickness.ShijieHuarenXiaohuaZazhi2005;13(24):2886-2888摘要目的:确定CT鉴别良恶性胃壁增厚的敏感性和特异性.方法:在螺旋CT和数字胃肠光盘中收集到40例螺旋CT见胃壁增厚,且在作CT检查前或后4wk内作过钡餐检查的患者.复习其CT表现,并以胃壁增厚的程度、对称度、分布和强化等特点确定CT发现恶性胃壁增厚的敏感性和特异性.结果:最后诊断胃炎20例、食道裂孔疝4例、良性溃疡3例、良性肿瘤3例、恶性胃肿瘤8例、正常2例.40例胃壁平均厚度14mm(7-65mm).胃壁厚度≥10mm诊断恶性肿瘤的敏感度100%,特异性为43%,而局限性、偏心性、强化型胃壁增厚的敏感度分别为93%、71%、43%,特异性为8%、75%、88%.综合≥10mm的胃壁增厚,且呈局限性、偏心性、强化者,其敏感性为36%,特异性上升到92%.结论:综合胃壁增厚呈局限性、偏心性且有强化等特点,则诊断恶性胃壁增厚的特异性可上升到92%.因此,这些患者...
