Abstract
OBJECTIVE: To differentiate the ultrasonographic characteristics of gastric stromal tumors (GSTs) and gastric schwannomas (GSs) identified via gastric filling ultrasonography and investigate the relationship between National Institutes of Health (NIH) risk stratification and the ultrasonographic imaging characteristics of GSTs. METHODS: A retrospective analysis was performed on the clinical and ultrasonographic imaging data of 77 patients with GSTs and 16 with GSs who were evaluated between 2020 and 2025. RESULTS: Statistically significant differences were observed in ultrasonographic findings, including tumor diameter, internal echo, morphology, and boundaries, between the GST and GS groups. Moreover, significant differences in the ultrasonographic features of GSTs were found across different NIH risk stratifications. Intermediate- or high-risk GSTs were closely associated with larger tumor diameters, more heterogeneous internal echoes, irregular shapes, indistinct boundaries, and abundant intratumoral blood flow. A scoring system was established based on significant ultrasonographic features derived from ROC curve analysis. CONCLUSIONS: Based on our analysis, gastric filling ultrasonography can be utilized to differentiate GSTs from GSs and predict the risk stratification of GSTs through an established ultrasound image scoring system. The clinical application of gastric filling ultrasonography may aid in the preoperative diagnosis of GSTs and the development of individualized treatment plans.