18F-FDGPET／CT与多层螺旋CT在进展期胃癌术前TNM分期的对比研究

目的应用18F-FDGPET／CT（PET／CT）与多层螺旋cT对进展期胃癌术前TNM分期进行对比研究，以期更客观地评估术前分期，指导治疗。方法对术前行PET／CT检查的39例及MSCT检查的40例进展期胃癌，分别进行术前TNM分期，将检测结果与术中所见及病理进行对照。结果PET／CT对原发灶、区域淋巴结、N3转移淋巴结的准确率分别为92．3％、66．7％、100．0％；而MSCT诊断的准确率分别为82．0％、50．0％、62．5％。结论（1）PET／CT和多层螺旋CT对原发灶、区域淋巴结转移的准确率都较高，差异无统计学意义，由于多层螺旋cT临床应用广泛且费用远低于PET／CT，是首选的检测手段；（2）PET／CT对N3转移淋巴结、远处转移灶检测的准确率明显高于多层螺旋cT，为临床提供更为全面客观的术前分期，指导治疗；（3）由于PET／CT也存在一定假阴性，结合腹腔镜检可减少或避免不必要的剖腹术。

Diagnostic value of 18F-FDG PET/CT in the preoperative advanced gastric carcinoma comparing with multi - slice spird computed tomography

Objective Evaluate the diagnostic value of PET/CT in the preoperative advanced gastric carcinoma comparing with muh;-sliee spiral computed tomography. Methods Thirty -nine advanced gastric carcinoma patients taking PET/CT and abstract 40 advanced gastric carcinoma patients performing MSCT be- fore operation,were done the TNM staging, and the results were compared with the operation histopathology. Results For diagnosing primary lesions, regional lymph nodes, N3 lymph nodes , PET/CT was accurate in 92.3% , 66.7% and 100.0%. Instead, MSCT was accurate in 82.0%, 50.0% and 62.5%. Conclusions （ 1 ） PET/CT and MSCT have high accuracy in diagnosing primary lesions and regional lymph nodes. But for detecting the N3 lymph nodes and distant metastasis, PET/CT has higher accuracy than MSCT. PET/CT combining abdominoscopy may decrease or avoid exploratory laparotomy.