64排CT三维血管重建术前对胃癌血管侵犯的评估  

Preoperative evaluation of the 64-slice spiral CT three dimensional angiography for vascular invasion in gastric cancer

作　　者：姚学清[1] 林锋[1] 张忠林[2] 郑仰[1] 吴伍林[1] 蔡观福[1] 李勇[1] 

机构地区：[1]广东省人民医院胃肠外科,广州510080 [2]广东省人民医院放射科,广州510080

出　　处：《中华胃肠外科杂志》2008年第5期440-443,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：广东省自然基金项目（5301056）

摘　　要：目的研究64排CT血管三维重建（3D CTA）进行胃癌术前评估中对肿瘤血管侵犯的诊断价值。方法对2006年8月至2007年12月间经胃镜确诊为胃癌并接受手术探查的40例患者进行术前CT影像的CTA重建，判断胃周血管侵犯情况，与术中探查结果对比。结果40例患者均成功进行CTA重建，14例提示血管侵犯的患者有12例术中探查证实血管侵犯；CTA判断血管侵犯的敏感性为98．1％，特异性为96．4％；术前CTA判断胃周血管是否受侵与手术判断的差异无统计学意义（X^2=0．0099．P〉0．05）。结论64排3DCTA可作为胃癌是否侵犯血管的有效评估手段。Objective To evaluate the preoperative diagnosis value of 64-slice spiral CT three dimensional angiography （3D CTA） for the vascular invasion in gastric cancer. Methods CT images of 40 patients diagnosed as gastric cancer by endoscope, who proceeded to surgical exploration from August 2006 to December 2007 ,were collected. These images were rebuilt by 3D CTA to judge vascular invasion by gastric cancer in comparison with the surgical finding as standard reference. Results Successful 3D CTA reconstructions were performed for all these 40 patient images. Out of 40 eases, 14 cases presented vascular invasion in the 3D CTA,and 12 of 14 cases were proved to have vascular invasion in the surgery. For assessing vascular invasion with CTA, the sensitivity was 98.1% and the specificity was 96.4% respectively（Chi Square X^2=0.0099,P〉0.05）. There was no significant differences regarding vascular invasion in gastric cancer between preoperative 3D CTA assessment and surgical finding. Conclusion Sixty-four-slice spiral CT 3D angiography is effective in assessing vascular invasion in gastric cancer and is also valuable in clinical application.

关 键 词：胃肿瘤 体层摄影术 螺旋64排 血管造影术 三维重建 

分 类 号：R735.2[医药卫生—肿瘤]