多层螺旋CT在胃癌术前分期中的临床应用  

Clinical application of multi-slice spiral computed tomography in the preoperative staging of gastric carcinoma

作　　者：曹晖[1] 刘骅[1] 陆明辉[1] 陈治平[1] 吴志勇[1] 龚红霞[2] 许建荣[2] 

机构地区：[1]上海交通大学医学院附属仁济医院普通外科,200127 [2]上海交通大学医学院附属仁济医院放射科,200127

出　　处：《中华胃肠外科杂志》2007年第4期346-349,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：上海市科委临床医学重点学科基金资助项目（054119501）

摘　　要：目的探讨多层螺旋CT（MSCT）在胃癌术前分期中的临床应用价值。方法2004年6月至2006年3月间经胃镜活检确诊为胃癌的患者89例，其中男性49例，女性40例，中位年龄63岁。所有患者均在手术前1周内进行MSCT检查。图像由2位资深放射科医师双盲阅读，术前判断患者的肿瘤TNM分期．并与患者的术后病理结果进行对照比较。结果与术后病理诊断比较，MSCT普通轴位图像结合多平面重建法判断胃壁侵犯程度的总准确率为72．3％，其中T1判断准确率为90．0％，T2为82．8％，T3为69．6％，T4为52．4％；判断淋巴结转移情况的总准确率为53．0％，其中N0判断准确率为44．0％，N1为72．0％，N2为46．4％，N3为2／5。MSCT对有远处转移即M1的患者判断准确率为90．0％。结论MSCT对胃癌患者进行术前TNM分期有较高的准确率，可以为胃癌患者术前提供一种无创且易于被接受的检查方法。Objective To evaluate the application of multi-slice spiral computed tomography （MSCT） in the preoperative staging of gastric carcinoma. Methods Eighty-nine cases of gastric carcinoma confirmed by endoscopic biopsy （including 49 men and 40 women） were collected between June 2004 and March 2006. MSCT was performed one week before operation and all the images were read by two radiologists. The results were compared with the postoperative pathologic findings. Results In general, the accuracy of MSCT in determining the T stage of gastric carcinoma was 68.7% based on axial and MPR images. The accuracy of diagnosis for T1 was 90.0% （9/10）, for T2 was 82.8% （24/29）, for T3 was 69.6% （16/23） and for T4 was 52.4% （11/21） respectively. The accuracy for MSCT in determining the N stage of gastric carcinoma was 51.8% in general. The accuracy of diagnosis for No was 44.0% （11/25）, for N1 was 72.0% （18/25）, for N2 was 46.4% （13/28） and for N3 was 40.0% （2/5） respectively. The accuracy of diagnosis for distant metastasis （M1） was 90% （9/10）. Conclusions The accuracy of MSCT in preoperative staging of gastric carcinoma is relatively high. It is easily accepted by the patients as a practical and noninvasive technique of gastric carcinoma staging.

关 键 词：胃肿瘤 体层摄影术 X线计算机 肿瘤分期 

分 类 号：R735[医药卫生—肿瘤] R730[医药卫生—临床医学]