多层螺旋CT在胃肿瘤诊断中的应用研究

目的 评价多层螺旋CT（MSCT）及其三维后处理技术在胃肿瘤诊断中的应用价值及影响因素。资料与方法 对23例经上胃肠道钡餐造影（GI）和胃镜检查诊断为胃肿瘤的患者行多层螺旋CT容积扫描，分别以多平面重建技术（MPR），3DCT技术（包括SSD和Ray Sum)和CT仿真胃镜技术（CTVG）进行后处理，分别评价所有重建影像显示胃肿瘤的能力以及影响因素，同时与上胃肠道造影及胃镜所见比较。结果 3DCT和CTVG诊断23例胃肿瘤的敏感性和准确性分别为95.5%和85.7%。以秩和检验比较，三维重建影像对胃肿瘤的整体显示效果接近GI和胃镜，但CTVG结合MPR影像对于评价粘膜下肿瘤的准确性则明显优于GI和胃镜。结论 综合运用MSCT及其多种后处理技术，在对胃肿瘤的检出，定位，分期等方面可发挥较大作用，是一种新的且具潜力的胃肿瘤检查方法，可作为传统检查方法的有益补充，在技术方面尚待进一步发展和完善。

Application of Multi-slice CT Scanning in the Diagnosis of Gastric Tumors

Objective To assess the clinical application of multi slice CT (MSCT) in the diagnosis of gastric tumors, and to compare CT findings with GI and gastroscopic results.Materials and Methods Multi slice volumetric helical CT scanning of the stomach was performed in 23 patients with gastric tumors. MPR, SSD, raysum and virtual gastroscopy (CTVG) image processing methods were used. The ability in revealing the tumors of different reconstructed images and the factors influencing the image quality were evaluated. CT findings were compared with the GI and gastroscopic results.Results The sensitivity and accuracy of all 3D images were 95.5% and 85.7%, respectively. Statistically (Sum rank test), the displaying result of 3D images for gastric tumors was approximate to that of GI and gastroscopy. Nevertheless, CTVG, when combined with MPR, was superior to GI and gastroscopy in assessing submucosal tumors. The factors influencing the quality of MSCT images included the distension of the stomach, patient's position, pitch, and stability of breath hold.Conclusion MSCT, together with multiple 3D imaging techniques, is of great value in detecting, localizing and staging the gastric tumors. As a new and promising technique, MSCT can be used as a helpful complement for the conventional examinations, although further improvement in the technique is required.