低频超声小探头联合螺旋CT检查对胃癌术前分期的评价

目的：回顾性分析低频超声小探头及多层螺旋CT检查在胃癌术前分期中的作用与价值，以进一步提高胃癌术前分期的诊断精度。方法：对1997年至2001年间120例胃癌患者采用7．5MHz的预置式小探头超声内镜系统进行术前探查，其中32例同时行多层螺旋CT扫描。所有研究对象在影像学检查后的2周内实施手术，并结合病理组织学结果对上述影像学发现进行对比。结果：低频超声小探头对T1—T4各期判断的准确率分别为90．O％、88．5％、91．5％、89．1％，螺旋CT分别为50．O％、67．8％、75．O％、88．9％。对N0--N2各期的准确率低频超声小探头分别为88．6％、70．1％、33．3％，而螺旋CT分别为62．5％、50．O％、75．O％。由于穿透深度的限制，低频超声小探头评价远处转移(M分期)的能力有限，而螺旋CT对M1的检出率高达75．O％。结论：低频超声小探头可对癌肿侵犯胃壁的深度作出较准确的判断，亦可反映近处淋巴结的转移情况；螺旋CT则更多体现于能较全面的评价各组淋巴结的状况尤其是诊断病灶周边脏器浸润和远处播散中的优势。

Retrospective evaluating low frequency mini-probe endosonography combined with spiral computed tomography in the preoperative staging of gastric carcinoma

Objective To improve the accuracy of the diagnosis of stomach cancer preoperatively and provide the reliable datum for the choice of the therapy pattern, we conduct the investigation of the effects and values of low frequency mini - probe endosonography ( LFMPS) and spiral computed tomography in the preoperative staging of gastric carcinoma. Methods From 1997 to 2001, 120 patients with histopatho-logical confirmed gastric carcinoma were preoperatively staged using the instrument of preliminary - placed mini - probe system. Thirty - two of the total patients were examined by spiral computed tomography with the results to be compared with the histological findings post-operatively. Results The diagnostic accuracy of LFMPS and spiral computed tomography for determination of the T stages, T1 , T2, T3, T4 were 90.0% , 88.5% , 91.5% , 89. 1% and 50.0% ,67.8% ,75.0% ,88.9% respectively. Meanwhile, the accuracy of the N stages, N0, N, , N2 were 88.6% % , 70. 1% , 33. 3% and 62. 5% , 50 . 0% , 75. 0% respectively. Due to the penetration depth of LFMPS is limited, its ability in evaluating the distant metastasis ( M staging) is unfavorable. On the contrary, the ability of detecting M1 by CT scanning reached 75.0%. Conclusion The mini - probe system with low frequency has a high accuracy in assessment of T stage and regional lymph node metastasis of gastric carcinoma, and spiral CT scanning has the superiority in evaluating the distant metastasis and the involvement of surrounding organs. It is suggested to adapt the merits of the two kinds of imaging modality together in the preoperative staging of gastric cancer to improve the accuracy in diagnosis.