64排螺旋CT多期增强扫描对进展期胃癌术前评估的价值

目的探讨64排螺旋CT三期增强扫描对进展期胃癌术前评估中的价值。方法选择CT检查前已确诊为胃癌的患者80例，术前行64排螺旋CT三期增强扫描，然后进行病理分期TNM分期，分析螺旋CT与病理分期的效果，并且探讨增强CT对于手术判断的效果。结果CT影像学主要表现为胃壁异常增厚、肿瘤向周围直接侵犯、局部和远处淋巴结转移，CT与病理诊断对比在T分期与N分期上有显著性差异（P〈0．05），而对M分期对比上无明显差异（P〉0．05）。CT预测治疗方式与临床相符合的敏感度为78．6％，特异性为86．5％，准确率为83．8％。结论多层螺旋CT（MSCT）可较准确地显示胃癌侵犯胃壁的深度、淋巴结转移和远处脏器的转移情况，在胃癌M分期判断上有较高的准确率，能为手术治疗方案选择提供参考。

The Value of multi-phase contrast enhanced CT scan with 64-slice spiral CT in TNM staging of advanced gastric carcinoma

Objective To discuss the values of 64 row of three periods of spiral CT enhanced scan for advanced gastric cancer in the preoperative assessment. Methods 80 gastric cancer patients diagnosed by CT examination were given preoperative 64 row of three periods of spiral CT enhanced scan for TNM staging, and The results were compared with postoperative pathologic staging, and the value of the judgment effects of enhanced scan for operative selection was explored. Results The CT imaging mainly showed the thickening of the gastric wall, the surrounding tissues directly violated by tumor, local and distant lymph node metastasis. The results of the CT and pathological diagnosis on the T stage and N staging had significant difference （ P 〈 0. 05 ）, while the M staging remains same （ P 〉 0.05 ）. The sensitivity, specificity and accuracy of CT prediction were 78. 6% ,86. 5% and 83. 8%. Conclusions MSCT can be relatively accurately show the depth of gastric cancer invasion of the stomach wall ,lymph node metastasis and distant organ metastasis, It has higher judgment accuracy in the M staging of gastric cancer that can provide a reference for the surgical treatment selection.