16层CT对进展期胃癌术前分期的价值

目的 探讨16层CT 对进展期胃癌术前的TNM分期的诊断价值. 方法 对60例临床诊断胃癌患者,16层CT平扫 增强扫描后进行容积重建处理,显示胃癌病变累及的部位、范围、大小、周围组织侵犯及局部淋巴结的情况,区别早期胃癌和进展期胃癌,进行TNM的分期. 结果 16层CT检查结果与手术及病理对照:T分期的准确性95%,能够显示黏膜及黏膜下层、肌层、浆膜层侵犯情况;N分期准确性95.7%,淋巴结检出水平明显提高;M分期检出率达100%.CT对胃癌诊断的敏感性100%,准确性93.3%,阳性预测值93.3%. 结论 16层CT 3期增强及图像后处理分析可提高胃癌T、M分期的准确性,是胃癌术前准确分期的可靠方法.CT扫描计划合理制定及3维重建方法合理选择影响病变的清晰显示.

Diagnostic Value of 16-Slices CT for The Preoperative Staging of Advanced Gastric Carcinoma

Objective To discuss diagnostic value of 16-slices CT for the preoperative TNM staging of advanced gastric carcinoma. Methods 16-slices CT using precontrast and postcontrast scanning was performed in 60 cases of clinical suspected gastric carcinoma. Images managed volume reconstruction in the figure workstation of Vitrea were showed the location, range, size and adjacent tissue of tumor invasion, as well as local lymph node status to distinguish early and advanced gastric carcinoma for TNM staging. Results Compared with surgery and pathology, T staging accuracy was 95 %, and 16-slices CT could show involvement status of mucosa, muscle and serosa, N staging accuracy was 95.7 %, N staging was marked difference compared with other Staging in the high detecting level of lymph node. M staging accuracy was 100 %. The sensitivity, accuracy and positive rate of 16-slices CT were for diagnosing of gastric carcinoma 100%, 93.3% and 93.3%, respectively. Conclusion 16-slices CT using triphase incremental scanning and image manageing improved the accuracy of T and M staging of gastric carcinoma and was credible means for the preoperative stage of gastric cancer, which was valuable to choose reasona- ble preoperative planning. The reasonable choice of CT scanning and three-dimensional reconstruction means can effect on clear show of tumour.