MSCT在胃癌病理分期及诊断中的应用价值  

The value of multi-slice CT in the pathology staging and diagnosis in patients with gastric cancer

作　　者：韦章诚[1] 吴家星[1] 夏玉梅[2] 符艳梅 

机构地区：[1]攀枝花市中西医结合医院放射科,四川617000 [2]攀枝花市中西医结合医院CT室,四川617000

出　　处：《放射学实践》2016年第5期402-406,共5页Radiologic Practice

基　　金：攀枝花市科技计划项目(2012CY-S-22(7))

摘　　要：目的:探讨胃癌的CT表现特征,评价其在分期诊断中的应用价值。方法:搜集有完整手术病理的胃癌患者500例,通过将CT检查结果与胃癌的大小、位置、形状、强化程度以及肿瘤侵犯范围进行对比,对CT的分期诊断准确度进行评价。结果:胃癌病灶长度、厚度与病理T分期均呈显著正相关(P<0.001)。胃癌病灶好发于胃窦及贲门部。500例胃癌患者中最常见的类型为蕈样型(79.0%,395/500)。胃癌病灶在静脉期及延迟期的CT值随着T分期逐级升高而增大,差异有统计学意义(P<0.05)。T3期中胃周脂肪模糊型所占比例为76.64%,T4期中浆膜高强化型所占比例为86.36%。MSCT诊断胃癌T1期的准确度为91.23%,T2期准确度为89.01%,T3期准确度为87.64%,T4期准确度为98.74%。结论:MSCT有助于更准确地判断肿瘤的浸润程度,能够较准确地对胃癌的T分期进行判断。Objective：To discuss the CT features of gastric cancer and to evaluate its value in pathology diagnosis and staging.Methods：Totally 500 patients with gastric cancer proven by surgery and pathology were retrospectively studied.The multi-slice CT（MSCT）manifestations including size,location,morphology,enhancement and invasion pattern were compared with pathology findings,the accuracy of CT staging was evaluated.Results：The length and depth revealing on MSCT showed significant positive correlation with pathology T staging（P〈0.001）.Gastric cancer mostly occurred in the gastric antrum and cardia.Of the 500 patients,the most common gross feature of tumor was fungoides type（79.0%,395/500）.The CT value in both venous and delayed phases increased as the upgrading of T staging,with significant statistical difference（P〈0.05）.Fine strands in perigastric fatty tissue showing on stage T3 was 76.64%,while on T4 was 86.36%.The accuracy of MSCT in the diagnosis of stage T1,T2,T3 and T4was 91.23%,89.01%87.64%and 98.74%respectively.Conclusion：MSCT is helpful in accurately judging tumor infiltration and T staging of gastric cancer.

关 键 词：胃肿瘤 体层摄影术 X线计算机 T分期 肿瘤分期 

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