多层CT胃镜与双对比上消化道钡餐诊断胃癌的比较研究  

Evaluation of Gastric Cancer with MSCT Gastroscope in Comparison to Double-Contrast Barium Meal

作　　者：魏文洲[1] 吴华旺[1] 

机构地区：[1]广东省广州市精神病医院放射科,广东广州510170

出　　处：《武汉大学学报（医学版）》2012年第4期559-562,589,共5页Medical Journal of Wuhan University

摘　　要：目的:通过与双对比上消化道钡餐(UGI)比较,研究多层CT胃镜(CTG)包括仿真胃镜(CTVG)和透明再现(TR)在胃癌术前诊断中的作用。方法:以手术病理检查结果为标准,分别计算CTVG、表面遮盖显示(SSD)、空气铸型成像(ACI)、Ray sum和上消化道钡餐(UGI)5种技术检出早期和进展期胃癌的准确率以及进展期胃癌Borrmann分型的准确率,分别比较CTVG、SSD、ACI、Ray sum和TR与UGI的结果。结果:CTVG检出早期和进展期胃癌的准确率与UGI相近(P>0.05),但SSD、ACI、Ray sum和TR均明显低于UGI(P<0.05)。CTVG胃癌Borrmann分型的准确率明显高于UGI(P<0.05),而Solid、Air和Ray sum的分型准确率则明显低于UGI(P<0.05),TR的分型准确率仅稍低于UGI,但差异无显著意义。结论:包括CTVG和TR在内的多层CT胃镜是术前评价胃癌的一种有价值的方法,CTVG可替代UGI来检测胃癌的病灶,SSD、ACI和Ray sum结合使用提高其诊断胃癌的价值。Objective： To evaluate the role of multi-slice CT gastroscopy including CT virtual gastroscopy（CTVG） and transparency rendering（TR） techniques in the assessment of gastric cancer as compared with conventional upper gastrointestinal imaging（UGI）.Methods： A total of 105 consecutive patients with gastric cancer were scanned by 64-slices CT.The accuracy of lesion detection and classification based on Borrmann classification of CTVG,surface-shaded display（SSD）,air cast imaging（ACI）,Ray sum and TR were analyzed by comparing with pathohistological results.Compared to that of UGI,the results of CTVG and TR（including SSD,ACI,and Ray sum results） images were assessed respectively.Results： There was no statistical significant difference for both early and advanced gastric cancer in detection accuracy between CTVG and UGI（P0.05）,but the lesion detection accuracy of SSD,ACI,Ray sum,and TR for EGC were lower than that respectively of UGI（P0.05）.The accuracy of Borrmann classification of CTVG was higher than that of UGI（P0.05）,and that between SSD,ACI,and Ray sum were lower than that of UGI（P0.05）,but TR was not significantly lower than that of UGI（P0.05）.Conclusion： CTG is a promising method for evaluating gastric cancer despite of its limitations,and CTVG can be used as a substitute of UGI in the detection of gastric cancer.The value of SSD,ACI,and Ray sum was limited in the assessment of gastric cancer when used alone clinically.

关 键 词：体层摄影术 X线计算机 胃癌 图像处理 计算机辅助 上消化道钡餐 

分 类 号：R735.2[医药卫生—肿瘤]