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Objective To compare the clinical and multidetector computed tomography (MDCT) features of gastroduodenal heterotopic pancreas (HP) and gastrointestinal stromal tumors (GIST) smaller than 3 cm in diameter. Methods A total of 61 patients pathologically confirmed as gastroduodenal HP (n=28) and GIST (diameter <3 cm, n=33) in Daping Hospital during 2012-2021 were included. Their clinical and MDCT features (including lesion location, growth mode, morphology, contour,size and MDCT multi-phase enhancements) were retrospectively reviewed and compared. The characteristics with significant difference between the two were searched as the index of differential diagnosis, and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficiency of each parameter. Results No significant difference existed in gender, body mass index (BMI), clinical symptoms and signs between the patients with gastroduodenal HP and GIST (P>0.05), while statistically significant differences existed in age, MDCT morphological features (location, growth pattern, lobulation sign) and CT values (plain CT value, portal venous phase CT value and enhancement value) between the two groups (P<0.05, P<0.01). Among them, age,location, and portal venous phase CT value had better efficiency, and the areas under ROC curves (AUC) were all greater than 0.700.When the 3 MDCT morphological features (location, growth pattern, lobulation sign) were combined in use, the AUC was improved to 0.954 (95%CI 0.867-0.991). The plain scan CT value, portal venous phase CT value and enhancement value can be separately used to distinguish HP and GIST respectively, and the portal venous phase CT value has the best efficiency. The optimal cut-offs of age, plain scan CT value, portal venous phase CT value and enhancement value were 50 years, 40.33 HU, 72.53 HU and 37.33 HU,respectively, which could be used as reference indicators to differentiate HP from GIST. Conclusion By comprehensively analyze the patient's age, lesion MDCT morphological features and multi-phase enhanced quantitative parameters, a preliminary differential diagnosis can be made between gastroduodenal HP and GIST smaller than 3 cm in diameter.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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