多排螺旋CT对胃癌T分期的诊断价值

目的 评价多排螺旋CT平扫及双期增强扫描在胃癌T分期的价值,探讨胃癌的浸润深度CT征象及其与手术病理特性的相关性.方法 收集57例经手术病理证实为胃癌的患者,分析其平扫、动脉期、静脉期及多平面重建图像.结果 多排螺旋CT对胃癌术前T分期诊断的准确性为78.94%;对T1期、T2期、T3期、T4期诊断的准确性分别为94.74%、94.74%、84.21%和87.72%;敏感性分别为25.00%、80.00%、78.26%和88.00%;特异性分别为100%、96.15%、88.24%和87.50%.结论 多排螺旋CT 平扫及双期增强扫描尤其是局部薄层重建、多平面重建能较全面、准确地进行胃癌病灶的诊断和T分期,有助于临床选择恰当的手术切除范围、手术方式和制定综合治疗方案.

Clinical Application of Mutidetector Computer Tomography in Diagnosing T Staging of Gastric Carcinoma

Objective To evaluate the significance of plain and dual-phasic enhanced MDCT in the diagnosis of preoperative T staging of gastric carcinoma. Methods MDCT examinations were performed on 57 patients with histopathologically confirmed gastric carcinoma. The scan protocol included plain scanning, arterial phase and portal phase scanning. The MPR image was reconstructed. Results The MDCT had 78. 94 % of accuracy for diagnosing T stage, and 94. 74%, 94. 74%, 84. 21% and 87. 72% accuracy for T_1, T_2, T_3, and T_4, respectively. The sensitivity of the diagnosis were 25. 00%, 80. 00%, 78. 26% and 88. 00% for T_1, T_2, T_3, and T_4 .respectively. The specificity of the diagnosis were 100% , 96.15% , 88. 24% and 87. 50% for T_1, T_2, T_3, and T_4, respectively. Conclusion The plain scan and dual phase enhanced scans of MDCT, especially the thin slice and MPR reconstruction with proper windows technique, have clinical significance for diagnosing T staging of gastric carcinoma.