VCT在胃癌术前分期中的应用价值

目的联合64排容积CT低张充气平扫、三期增强扫描及后处理技术对胃癌病例进行术前分期,并与手术病理结果对照,探讨容积CT对胃癌术前分期的准确性及其临床应用价值。方法收集经手术病理确诊胃癌病例40例。所有病例均行低张充气平扫、三期增强扫描及后处理重建（MPR、SSD、VR、MIP、RaySum、CTVE等）。由两位高年资医师采用双盲法对同一病例分别评估癌灶部位、大小、范围、周围结构及血管侵犯、淋巴结转移情况,得出客观结果分别与手术病理结果相对照。判定结果采用国际抗癌联盟通用的TNM标准并参考日本胃癌规约。结果 64排容积CT对胃癌的肿瘤（T）分期准确率达87.5%,淋巴结转移（N）分期准确率达92.5%,远处转移（M）分期准确率达97.5%。本研究组中容积CT术前分期经与病理结果对照显示有较强的一致性。结论 64排容积CT对胃癌分期的准确率较高,对胃癌治疗和判断预后具有指导意义,值得在临床大力推广。

The application value of volume computed tomography in preoperative staging of gastric cancer

Objective To stage gastric cancer before surgery by combination of 64 rows of volumetric CT hypotonic aeration scan,three phases enhancement scanning and post-processing techniques,compare with surgical pathology results,and discuss the accuracy of volumetric CT in preoperative staging of gastric cancer and its clinical application value.Methods 40 cases of patients with gastric cancer confirmed by surgery and pathology were selected and underwent hypotonic aeration scan,three phases enhancement scanning and post-processing techniques(MPR,SSD,VR,MIP,RaySum,CTVE,etc.).Tumor location,size,scope,surrounding structures and blood vessels violations,lymph node metastasis were analyzed by two experienced radiologists.The results were compared with surgical pathology.International cancer alliance universal TNM standard and Japanese gastric cancer stipulations were adopted to judge outcomes.Results The accuracy of 64 slice VCT in T-staging,N-staging and M-staging were 87.5%,92.5% and 97.5%,respectively.Staging results of VCT and pathologic results had good consistency.Conclusion The accuracy of 64 slice VCT in staging of gastric cancer is high,which has guiding significance in stomach cancer treatment and prognosis judgement.It is worthy of clinical application.