64层螺旋 CT 三期增强扫描对胃癌转移性淋巴结的诊断价值  

Diagnostic value of 64-slice spiral CT triple-phase enhanced scan in evaluation of lymphatic metastasis of gastric cancer

作　　者：周小燕[1] 马隆佰[1] 黄顺荣[2] 林家威[2] 吴东波[2] 李传[1] 蒋朝龙[1] 李鹰[1] 张小容[1] 

机构地区：[1]广西壮族自治区人民医院1放射科,广西南宁530021 [2]广西壮族自治区人民医院胃肠外科,广西南宁530021

出　　处：《实用放射学杂志》2014年第8期1316-1319,共4页Journal of Practical Radiology

基　　金：广西自然科学基金项目（桂科自0991216）.

摘　　要：目的：探讨64层螺旋 CT（64-MSCT）三期增强扫描对胃癌转移性淋巴结的诊断价值。方法对30例胃癌患者行64-MSCT 平扫及三期增强扫描，分析胃周转移性淋巴结相关参数。结果判断胃周淋巴结是否转移的参数为：①淋巴结短径≥6 mm；②淋巴结短长径比≥0.6；③淋巴结门脉期 CT 值≥65 HU；④淋巴结门脉期与平扫期 CT 值差≥35 HU。①、②2项参数联合诊断的灵敏度为90.5%，特异度为29.0%；①、②、③3项参数联合诊断的灵敏度为98.2%，特异度为19.4%；4项参数联合诊断的灵敏度为99.7%，特异度为13.2%。另外，淋巴结的形态符合环形强化或粘连成团之一者，亦考虑为转移性淋巴结。结论64-MSCT 三期增强扫描综合应用淋巴结的各项参数，可对胃癌周围淋巴结是否转移做出比较可靠的诊断，具有快速、无创伤、灵敏度较高的特点。Objective To investigate the clinical value of 64-slice spiral computed tomography（64-MSCT）triple-phase enhanced scan in diagnosis of lymphatic metastasis of gastric cancer.Methods Thirty patients with gastric cancer underwent plain and triple-phase enhanced scan by using 64-MSCT to analyze the relevant parameters of lymphatic metastasis.Results The four parameters determined metastatic perigastric lymph node as follows：①the short diameter ≥6 mm,②the ratio of short-to-long diameter ≥0.6,③the CT value in the portal venous phase≥ 65 HU,④the difference of CT values between portal venous phase and plain scan≥35 HU.The sensitivity and specificity of combining two parameters （①＋②）in diagnosing metastatic lymph node were 90.5% and 29.0%,respectively.The sensitivity and specificity of combining three parameters （①＋②＋③）were 98.2% and 1 9.4%,respectively.The sensitivity and specificity of combining four parameters （①＋②＋③＋④）were 99.7% and 13.2%,respectively.In addition,metastatic lymph nodes were considered if they were ring-enhancement,or adhesions of several lymph nodes.Conclusion The use of 64-MSCT triple-phase enhanced scan and synthesis of various parameters of lymph nodes could lead to reliable diagnosis of lymphatic metastasis in gastric cancer with rapid,non-invasive,high sensitive and specific features.

关 键 词：计算机体层成像 胃癌 淋巴结 

分 类 号：R814.42[医药卫生—影像医学与核医学] R735.2[医药卫生—放射医学]