64排螺旋CT增强扫描在胃肠道上皮内瘤变诊断及其与早期癌鉴别诊断中的价值  

The value of enhanced multiphasic 64 multi-detector spiral CT in detection and differentialdiagnosis of intraepithelial neoplasia and early cancer in gastrointestinal tract

作　　者：邱伟[1] 范国华[1] 张维[1] 

机构地区：[1]苏州大学附属第二医院影像科,江苏苏州215004

出　　处：《实用放射学杂志》2014年第3期455-458,462,共5页Journal of Practical Radiology

摘　　要：目的 探讨64排螺旋CT（64-MDCT）增强扫描对胃肠道上皮内瘤变（IEN）诊断及其与早期胃肠道癌的鉴别诊断价值。方法 回顾性分析67例经病理证实为IEN患者的CT增强表现，其中低级别IEN 25例（胃10例、结直肠15例）、高级别IEN 42例（胃16例、结直肠26例）。分析胃肠道不同级别IEN的胃肠道壁黏膜厚度及其增强各期ΔCT值的变化，并进行统计学分析。结果 胃IEN与正常对照组间门脉期及平衡期ΔCT值比较差异均有统计学意义（t=3.93，P=0.01；t=2.19，P=0.03）；胃IEN与早期胃癌间三期ΔCT值比较差异均无统计学意义。结直肠IEN与正常对照组动脉期ΔCT值比较差异有统计学意义（t=2.84，P=0.006）；低级别与高级别组间门脉期ΔCT值比较差异有统计学意义（t=3.28，P=0.003）；并且低级别IEN与早期肠癌门脉期ΔCT值比较差异有统计学意义（t=3.28，P=0.003）。低级别IEN与高级别IEN胃肠道黏膜增厚约4~5 mm，2组黏膜厚度比较差异无统计学意义。结论 64排螺旋CT增强扫描有助于胃肠道IEN的诊断及其与早期胃肠道癌的鉴别诊断，并对IEN的分级具有一定的价值。Objective To study the value of enhanced multiphasic 64 multi-detector spiral ential diagnosis of the intraepithelial neoplasia（ IEN） and early cancer in gastrointestinal tract. eluded in our study and underwent 64-MDCT scanning, who were confirmed by path stomach, 15 in colorectum） and 42 high-grade ones （16 in stomach, 26 in nal wall and its changes of enhanced CT value in triphases were analyzed. colorectum）. Results Th ologic The t ere CT{64-MDCT） in detection and differ Methods Sixty-seven patients were in results with 25 low-grade IEN （10 in hickness of the the changes of CT value between gastric IEN and normal wall in portal venous and equilibrium statistically phases（ t= 3 mucosa of gastrointesti significant differences in 93, P=0.01; t=2.19, P = 0.03 ）, however no significant difference was seen between gastric IEN and early cancer. There were significant differences in the changes between colorectal IEN and normal wall in arterial phase（t=2.84,P= 0. 006）, between low-grade and high grade IFN in portal phase（t=3.28, P=0. 003） , and between low-grade IEN and early colorectal cancer in portal phase（t=3.28, P=0. 003}. The thickness of gastrointestinal tract mucosa was about 4-5 mm in both low-grade and high-grade IEN, which did not show a significant difference. Conclusion MDCT can provide useful information to improve the diagnosis and differentiation of IEN and early cancer in gastrointestinal tract, and has a certain value in classification of IEN.

关 键 词：上皮内瘤变 早期癌 胃肠道 计算机体层成像 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]