摘要目的：探讨CT在胃平滑肌瘤（ GLMs）和胃间质瘤（ GST）鉴别诊断中的价值。方法回顾性分析手术病理证实的、肿瘤最大径≤5 cm的65例GST患者和13例GLMs患者的CT表现，对肿瘤大小、位置、形态、生长方式、强化方式、强化程度、囊变、钙化、溃疡、肿瘤周围淋巴结以及患者临床资料进行独立评估。采用受试者工作特征曲线（ ROC曲线）分析肿瘤三期扫描CT值鉴别GST和GLMs的效能。结果 GST组和GLMs组患者的肿瘤形态、生长方式、钙化情况、溃疡情况及患者性别的差异均无统计学意义（均P＞0．05）。 CT检查显示，GST组和GLMs组的平扫CT值、动脉期增强幅度（ DE1）、肿瘤最大径、位置和强化方式的差异有统计学意义（均P＜0．05）。 ROC曲线显示，当肿瘤最大径＜3．2 cm时，其诊断GLMs的曲线下面积、敏感度和特异度分别为0．707、92．3％（12／13）和60．6％（40／66）；当患者年龄＜59岁时，其诊断GLMs的曲线下面积、敏感度和特异度分别为0．773、92．3％（12／13）和46．2％（30／65）；当DE1＜10．9 HU时，其诊断GLMs的曲线下面积、敏感度和特异度分别为0．774、84．6％（11／13）和77．3％（51／66）；当平扫CT值＞30．3 HU时，其诊断GLMs的曲线下面积、敏感度和特异度分别为0．731、84．6％（11／13）和65．2％（43／66）。结论 CT检查结合患者临床资料对肿瘤最大径≤5 cm的GLMs和GST的鉴别诊断具有重要参考价值。

abstractsObjective To explore the application value of CT imaging in differentiating gastric stromal tumors ( GST) from gastric leiomyomas ( GLMs) . Methods CT images of patients with GST ( n=65) or GLMs ( n= 13, maximum diameter of tumor ≤5 cm ) proved by surgery and pathology were retrospectively analyzed. The tumor size, location, contour, growth pattern, degree and pattern of enhancement, calcification, necrosis, surface ulceration, lymph nodes, and patient clinical data were evaluated by two independent reviewers. Receiver operating characteristic ( ROC) curves were employed to assess the measurement and calculation parameters in the differentiation of GST and GLMs. Results Between the GST and GLMs groups, there was no statistically significant difference in the contour, growth pattern, calcification, surface ulceration, and patient's sex ( P>0.05) . CT values of in plain scans, degree of enhancement in arterial phase ( DE1 ) , size, location and pattern of enhancement were found to be different between GST and GLMs ( P<0.05) . When the cutoff value of the maximum tumor diameter was 3.2 cm, the area under ROC curve, sensitivity and specificity were 0.707, 92.3%(12/13) and 60.6%(40/66), respectively. When the cutoff value of age was 59 years, the area under ROC curve, sensitivity and specificity were 0.773, 92.3% (12/13) and 46.2% (30/65), respectively. Taking the cutoff value of 10.9 HU as the degree of enhancement in arterial phase (DE1), the area under ROC curve, sensitivity and specificity were 0.774, 84.6% (11/13) and 77.3% (51/66), respectively. Using a cutoff value of 30.3&nbsp;HU, the sensitivity, specificity, and the area under ROC curve were 84.6% (11/13), 65.2% (43/66), and 0.731, respectively. Conclusions CT examination in addition to clinical data can be very helpful for the differential diagnosis of GLMs from GSTs in maximum diameter ≤5 cm.