16层螺旋CT胃癌术前TNM分期  

16-slices spiral-CT for preoperative TNM staging of gastric carcinoma

作　　者：李震[1] 胡道予[1] 肖明[1] 张进华[1] 宋金梅[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《放射学实践》2004年第8期599-602,共4页Radiologic Practice

基　　金：湖北省自然科学基金项目 (2 0 0 2AB1 30 )

摘　　要：目的 :评价 16层螺旋CT双期增强扫描在胃癌TNM分期中的诊断价值。方法 :2 9例胃癌患者 ,术前采用 16层螺旋CT平扫和动脉期、静脉期双期增强扫描 ,随后薄层重建 ,采用容积再现法 (VR)、多平面容积重建法 (MPVR)、表面遮盖显示 (SSD)和仿真内镜 (CTVG)技术重建 ,结合原始图像TNM分期 ,与术后病理对照 ,评价CT在胃癌TNM分期中的诊断价值。结果 :2 9例胃癌患者T分期 :T1期敏感度为 5 0 % ,特异度 5 0 % ;T2 期敏感度 87.5 % ,特异度 70 % ;T3 期敏感度 85 .7% ,特异度 80 % ;T4期敏感度 10 0 % ,特异度 83 .3 %。N分期 :N0 期敏感度为 71.4% ,特异度 71.4% ;N1期敏感度 80 % ,特异度 66.7% ;N2 ～N3 期敏感度为 83 .3 % ,特异度 66.7%。M1期敏感度和特异度均为 10 0 %。结论 :16层螺旋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。Objective:To evaluate the diagnostic value of 16-slices spiral computed tomography double-phase scans in the stomach cancer TNM staging. Methods:Twenty-nine gastric carcinoma patients were scanned on 16-slices spiral-CT including plain scans and dual phase enhanced scans respectively.The source images were reconstructed into thin slices and three-dimensional images using the technique of volume rendering (VR),multiplanar volume reconstruction (MPVR),shaded surface display (SSD) and CT virtual gastroscopy (CTVG).Combining the sources images,TNM stagings were assessed.Operative findings and pathological diagnosis were correlated with that of spiral CT findings. Results:In the twenty-nine gastric carcinoma patients,for the evaluation of T 1 staging:the sensitivity was 50% and the specificity was 50%;for T 2 staging: sensitivity 87.5%, specificity 70%;for T 3 staging: sensitivity 85.7%,specificity 80% and for T 4 staging:sensi- tivity 100%,specificity 83.3%.For N 0 staging:the sensitivity was 71.4% and the specificity was 71.4%; N 1 staging:sensitivity 80%,specificity 66.7%;and N 2～N 3 staging:sensitivity 83.3%,specificity 66.7%.The sensitivity and the specificity of M 1 staging were 100% respectively.Conclusion:Combining the reconstruction technique,16-slices spiral-CT can evaluate gastric carcinoma for TNM staging well.The technique is valuable for guiding the treatment planning.

关 键 词：16层螺旋CT 胃癌 TNM分期 X线计算机 肿瘤 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]