多排螺旋CT双期扫描三维重建技术胃癌评估(英文)

目的评价多排螺旋 CT 双期增强扫描三维重建技术在胃癌 TNM 分期中的诊断价值。方法 29例胃癌患者,术前采用一次闭气扫描技术,进行多排螺旋 CT 平扫和动脉期、静脉期双期增强扫描。扫描前15 min 肌注盐酸山莨菪碱20 mg,检查时口服产气粉两包。肘静脉团注对比剂后,进行增强扫描,得到的图像随后进行薄层重建,采用容积再现法(VR)、多层面容积重建法(MPVR),表面遮盖显示(SSD)和仿真内镜技术(CTVG)重建,结合原始图片 TNM 分期,与术后病理相对照,评价在胃癌 TNM 分期中的诊断价值。结果 29例胃癌患者,T 分期:T_1期敏感性为50%,特异性50%,T_2期敏感度为87.5%,特异度77.8%,T_3期敏感度为83.3%,特异度76.9%,T_4期敏感度为100%,特异度80%。在 N 分期上,N_0期敏感度为83.3%,特异度71.4%,N_1期敏感度为87.5%,特异度77.8%,N_2～N3期敏感度为81.8%,特异度75%。M_1期敏感度和特异度均为100%。结论多排螺旋 CT 双期增强扫描结合重建技术能够较好地进行 TNM 分期,有效地指导手术方案的选择。

Assessment of Gastric Cancer:Value of Two-phase Multidetector-row Spiral CT Three-dimensional Reconstruction Technique

Objective:To evaluate the diagnostic value of two-phase multidetector-row spiral CT three- dimensional reconstruction technique in TNM staging of gastric cancer.Methods:In 29 patients with gastric carcinoma pathologically conformed,plan scans were done firstly.Two-phase spiral CT was per- formed within one breathhold each.Distension of the stomach was achieved by intravenous application of anisodamine and effervescent granules.After bolus injection of contrast medium,scanning was per- formed in the arterial and venous phase,and the source images were thin reconstructed.The stomach to three-dimension analysis was constructed by volume rendering(VR)multiplanar volume reconstruction (MPVR),shaded surface display(SSD)and CT virtual gastroscopy(CTVG)technique.In combination with the sources images,gastric tumour invasion and lymph node metastasis was assessed,and TNM stag- ing was performed.Results:In 29 cases of gastric carcinoma,the sensitivity and specificity of two-phase multidetector-row spiral CT three-dimensional reconstruction technique in T_1,T_2,T3 and T_4 staging, the sensitivity and specificity was 50% and 50%,87.5% and 77.8%,83.3% and 76.9% and 100% and 80% respectively.For the N staging,the sensitivity and specificity in No,N_1,and N_2-N_3 was 83.3% and 71.4%, 87.5% and 77.8% and 81.8% and 75% respectively.The sensitivity and the specificity for M_1 staging was 100%.Conclusion:The reconstruction technique in combination with 16-slices spiral-CT can perform TNM staging well and effectively guide the choice of the surgical procedures for gastric cancer.