64层CT三期动态增强扫描对胃癌术前TNM分期的判断价值  

Clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM stagingassessment of gastric carcinoma

作　　者：钟宝元[1] 刘艳秀[5] 黄文峰[3] 刘清泉[2] 刘少强[4] 刘瑶[3] 

机构地区：[1]赣南医学院第一附属医院普外一科,江西赣州341000 [2]赣南医学院第一附属医院急诊外科,江西赣州341000 [3]赣南医学院第一附属医院消化内科,江西赣州341000 [4]赣南医学院第一附属医院影像科,江西赣州341000 [5]赣州市人民医院妇产科

出　　处：《中华胃肠外科杂志》2012年第7期706-709,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金

摘　　要：目的探讨64层螺旋CT三二期动态增强扫描对胃癌进行术前TNM分期的临床价值．方法回顾性分析2009年5月至2011年5月赣南医学院第一附属医院收治的120例胃癌患者的术前64层螺旋CT三期动态增强扫描资料和术后病理资料，由两名高年资影像科医生采用双盲法进行术前影像学分期。结果术前64层螺旋CT增强扫描对胃癌T分期判断的总体准确率为79．2％（95／120），其中对T1、T2、T3和T4期判断的准确率分别为66．7％（10／15）、66．7％（14／21）、84．0％（42／50）和85．3％（29／34）。对于单层胃壁结构和多层胃壁结构，CT增强扫描对T分期的准确率分别为59．4％（19／32）和81．8％（72／88）．差异有统计学意义（P〈0．05）。CT增强扫描对N分期判断的总体准确率为73．9％（85／115），其中对N0N1和N2期判断的准确率分别为75．5％（37／49）、70．3％f26／37）和75．9％（22／29）：对M分期判断的准确率为89．2％（107／120）。结论64层螺旋CTi期动态增强扫描可早期动态观察肿瘤累及侵犯情况、淋巴转移及远处转移的情况．有望成为胃癌术前分期有重要意义的检佥项目之一。Objective To explore the clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM staging assessment of gastric carcinoma. Methods A retrospective study was peffomled to review the 64-slice spiral 3-phase CT enhanced scanning of 120 patients with gastric cancer diagnosed by biopsy prior to operation and postoperative pathological reports. All the findings were reviewed by two senior radiologic diagnosticians separately and compared with pathological findings. Results The accuracy of 64-slice spiral CT enhanced scan was 79.2%（95/120） for T staging, 66.7% （10/15） for T1, 66.7%（14/21） for T2, 84.0% （42/50） for T3, and 85.3% （29/34） tbr T4. For gastric wall with single layer and multiple layers, the accm＇acy of CT enhanced scanning was 59.4% （19/32） and 81.8%（72/88） for T staging, and the difference was statistically significant（P〈0.05）. The accuracy of 64-slice spiral CT enhanced scan was 73.9% （85/115） for N staging, 75.5% （37/49） for NO, 70.3% （26/37） for N1, 75.9% （22/29） for N2. The accuracy of 64-slice spiral CT enhanced scanning was 89.2% for M staging. Conclusion 64-slice spiral CT 3-phase enhanced scanning can monitor the invasion, lymphatic metastatsis, and distant metastasis of gastric cancer dynamically, which may become an important examination item for the preoperative evaluation of gastric cancer.

关 键 词：胃肿瘤 体层摄影术 X线计算机 TNM分期 诊断 

分 类 号：R735.2[医药卫生—肿瘤]