MDCT联合气钡双对比造影在胃食管连接部癌中诊断的临床价值研究  

Analyzing the Value of MDCT and CD in the Diagnosis GEJ Carcinoma

作　　者：帖琳 高希春[1] 

机构地区：[1]张掖市人民医院,甘肃张掖734000

出　　处：《中国初级卫生保健》2013年第7期116-119,共4页Chinese Primary Health Care

摘　　要：目的运用MDCT联合气钡双对比造影对胃食管连接部(GEJ)癌进行术前分型及TNM分期,评价二者对GEJ癌的诊断价值。方法采用西门子64排CT进行胸腹联合扫描并重建,确定肿瘤中心位置,根据siewert分型标准进行分型,并将影像结果与手术记录、术后病理结果对照。同时结合MDCT图像和气钡造影进行术前TNM分期,并将影像结果与病理结果对照。结果本试验38例患者均经手术证实,其中Ⅰ型4例、Ⅱ型17例、Ⅲ型17例。MDCT对Ⅰ、Ⅱ、Ⅲ型诊断的敏感性分别为80%、88.9%和88.2%,特异性分别为97.1%、86.4%和95.6%。病理证实T_(1-2)例,T_3期6例,T_4期30例,MDCT对T_(1-2)、T_3和T_4分期诊断的敏感性分别为75%,66.7%和86.0%,特异性分别为94.4%,88.2%和90.0%。结论 MDCT联合气钡双对比造影检查可以为GEJ癌的分型、TNM分期提供客观、有效的评判标准,有助于判断淋巴结转移及远处转移,从而明确病人归属,判定合理的治疗方案。OBJECTIVE To evaluate the value of preoperative TMN staging and classification with MDCT and CD reformatted techniques. Provide important information to the treatment as well.METHODS By defining the left chronic angle as the Z-line and according to the Siewerts criterion,the distance and the TNM staging was measured as the classification.Those findings of MDCT were compared with surgical-pathological results as the golden references.RESULTS All 38 cases were confirmed by surgical-pathological results.There are 4 cases of typeⅠ,17 cases of typeⅡ,and 17 cases of typeⅢ.The sensitivity and specificity of typeⅠ,Ⅱ,Ⅲwere 80%,88.9%, 88.2%and 97.1%,86.4%,95.6%respectively.There are 4 cases of T_(1～2),6 cases of T_3,and 30 cases of T_4.The sensitivity and specificity of T_(1～2),T_3,T_4 by MDCT examination were 75%,66.7%,86.0%and 94.4%,88.2%,90.0%.CONCLUSION MDCT and CD technique can provide an objective and effective criteria in determining the classification and preoperative TNM staging for patients with GEJ carcinoma so that a appropriate therapeutic schedule could be explored.

关 键 词：胃食管连接部癌 多排螺旋CT 钡餐检查 分型 

分 类 号：R735[医药卫生—肿瘤]