Simple scoring model based on multi-slice spiral CT in differentiation between focal esophageal carcinoma and esophageal leiomyoma / 中国医学影像技术

ABSTRACT

Objective: To explore the efficiency of simple scoring model based on multi-slice spiral CT (MSCT) for differential diagnosis of focal esophageal carcinoma and esophageal leiomyoma. Methods: Totally 46 patients with focal esophageal carcinoma and 21 with esophageal leiomyoma who underwent preoperative chest enhanced CT were retrospectively analyzed. The lesion's location, density, size (the thickest wall on axial position and the longest diameter on multi-planar reconstruction [MPR]), the ratio of the longest diameter on MPR to the thickest wall on axial position, enhancement degree, tumor-air surface, peritumoral fat space and enlarged lymph nodes were assessed, and Logistic regression analysis was used to select MSCT signs significantly different between two diseases to establish a simple scoring model. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficiency of this model. Results: The ratio of the longest diameter on MPR to the thickest wall on axial position (odds ratio [OR]=0.154, 95%CI [0.033, 0.722]), enhanced CT value (OR=0.928, 95%CI [0.866, 0.994]), tumor-air surface (OR=0.028, 95%CI [0.004, 0.184]) were significantly different between focal esophageal carcinoma and esophageal leiomyoma(P65.5 HU was defined as 1 point, the ratio of the longest diameter of MPR to the thickest wall on axial position >1.61 as 2 points, and the unsmooth tumor-air surface as 4 points. Taken 2.5 points as the cutoff value for diagnosing esophageal carcinoma, the area under curve (AUC) of this model was 0.945 (95%CI [0.891, 0.999]), better than that according to single features (P<0.05). Conclusion: The simple scoring model based on MSCT was helpful to differentiation of focal esophageal carcinoma from esophageal leiomyoma and improving diagnostic efficiency.