进展期胃癌的多排螺旋CT和胃镜检查的对比研究  

Comparative Study of MSCT and Gastroscope in Diagnosis of Advanced Gastric Cancer

作　　者：冯元春[1] 郭玉林[1] 陈勇[1] 侯登华[1] 朱力[1] 王卉[1] 王晓东[1] 龚瑞[1] 陈志强[1] 马菁[1] 

机构地区：[1]宁夏医学院附属医院放射科,银川750004

出　　处：《宁夏医学院学报》2007年第6期580-582,共3页Journal of Ningxia Medical College

基　　金：宁夏回族自治区科技攻关重点项目(课题号2003-014-02;K2004-09)

摘　　要：目的通过多排螺旋CT(MSCT)检测进展期胃癌(AGC)的大体分型和浸润情况,探讨MSCT和胃镜对胃癌的诊断价值。方法82例经过手术证实的进展期胃癌病人,术前行腹部MSCT扫描检查。观察胃癌大体Borrmann分型,并和胃镜比较;在增强扫描下,观察癌肿在胃壁内外浸润(T分期),周围淋巴结肿大转移(N分期),周围的脏器侵犯(M分期)。结果82例AGC中:MSCT诊断BorrmannⅠ型19例,BorrmannⅡ型23例,Bor- rmannⅢ型31例,BorrmannⅣ型9例。T分期诊断准确率78%;N分期诊断准确率为62.9%;M分期诊断准确率为84%。胃镜诊断结果:BorrmannⅠ型19例,BorrmannⅡ、Ⅲ型共57例,BorrmannⅣ型6例。结论在Borrmann分型上MSCT优于胃镜,尤其对于BorrmannⅡ型与BorrmannⅢ型胃癌的鉴别、以及BorrmannⅣ型胃癌的诊断敏感性和准确性高于胃镜;胃癌造成邻近侵犯黏连和周围淋巴结和脏器转移情况的判定方面,MSCT具有独特优势。Objective To observe the gross classification and the invading depth of advanced gastric cancer in MSCT. To compare the diagnosis value of MSCT and gastroscope in patients with AGC. Methods Grosss Borrman＇ s classification were observed in 82 AGC cases proved by operation and compared with gastroscope resalts. Under contrast scanning, observing T, N and M staging preoperatively： the depth of tumor invading into and out the gastric wall （tumor staging） ;the involvement of regional lymph nodes（nodal staging） ,the presence or absence of metastatic （metastatic staging） on transverse and volumetric CT images. Results Gross classification： 19 cases were Borrmann type Ⅰ,23 cases Borrmann type Ⅱ and 31 cases Borrmann type Ⅲ,9 cases Borrmann type Ⅳ. The diagnosis accuracy of T staging were78 %, N staging were 62.29%, and M staging were 84%. The results of gastroscope were：The cases in Borrmann type Ⅰ were 19 cases,type Ⅱ and type Ⅲ 57 cases,type Ⅳ 6 cases. Conclusion Our findings indicate that MSCT is superior to gastroscopic examination in the Borrmann＇ s classification of AGC. The diagnosis sensitivity and accuracy of MSCT in Borrmann Ⅳ are also superior to gastroscope. In addition, MSCT play a special role in judge of peripheral nodes or organs＇ metastasis.

关 键 词：胃癌 分型 分期 计算机断层扫描 动态增强 胃镜 

分 类 号：R735.2[医药卫生—肿瘤]