64排螺旋CT扫描在食管癌术前分期诊断和制定手术方案中的价值

目的 探讨64排螺旋CT扫描在食管癌术前分期诊断和制定手术方案中的价值.方法 对病理确诊的50例食管癌患者术前进行多层螺旋CT(MSCT)检查,利用工作站进行后处理以获取CT仿真内镜(CTVE)、多平面重建(MPR)、表面阴影成像(SSD)和透明显示(Raysum)图像,并结合横断面图像,记录术前MSCT分期和预计手术方案,与术后病理分期和实际手术方案进行比较.结果 所有患者均顺利完成MSCT检查,均有阳性发现.MSCT对于食管癌术前T分期诊断的敏感度为100.0％(50/50),N分期诊断的敏感度为80.0％ (16/20),预测食管癌患者的手术切除率为96.0％ (48/50).MSCT术前评估得到CT-TNM分期准确率为90.0％,与病理TNM分期高度一致(Kappa =0.811,P＜0.05).结论 MSCT可以有效地显示肿瘤形态、大小和部位,确定肿痛的侵犯范围、淋巴结转移和远处转移等,对食管癌患者进行术前评估,为临床医师预测食管癌手术方案提供依据.

Diagnostic and application value of 64-slice spiral CT scanning in preoperative staging of esophageal cancer

Objective To investigate the diagnostic and application value of pre-operative 64-slice spiral CT evaluation in operation selection for esophagus cancer. Methods Multi-slice computed tomography (MSCT) was conducted in 50 patients with esophageal cancer before operation,using the work station for after-treatment to get CT virtual endoscopy (CTVE),multiplanar reconstruction (MRP),shaded surface display (SSD) and Raysum images, and combined with the transect images to record the preoperative MSCT staging and to predict the operation scheme,and compared with the postoperative pathological staging and the actual operational plan. Results The diagnostic sensitivity of MSCT for preoperative T staging was 100.0％ (50/50),while the N staging was 80.0％ (16/20).According to the MSCT prediction,the resection rate of esophageal cancer was 96.0％ (48/50).Through the preoperative MSCT evaluation,the accuracy of CT-TNM stage was 90.0％,highly consistent with the pathological TNM stage (Kappa =0.811,P ＜ 0.05 ). Conclusions MSCT can effectively display the shape,size and position of the tumor,determine the tumor invasion range,lymph node metastasis and distant metastasis,etc.,make preoperative evaluation for esophagus cancer patients and provide evidence for clinicians to predict the operation scheme for esophagus cancer.