溃疡型胃癌螺旋CT诊断:与钡餐、胃镜及标本比较研究  

Spiral CT Diagnosis of Gastric Ulcerative Carcinoma: A Comparison with GI, Fiberoptic Gastroscopy and Surgical Findings

作　　者：郑凯尔[1] 陈峰[1] 孙军[1] 居胜红[1] 郏爱明[1] 张俭[1] 孟爱芳[1] 

机构地区：[1]东南大学附属中大医院放射科,南京210009

出　　处：《临床放射学杂志》2002年第8期618-622,共5页Journal of Clinical Radiology

基　　金：EAR ECRFellowshipGrant:ResearchandEducationFundECR 2 0 0 0;江苏省卫生厅重点资助

摘　　要：目的　与胃钡餐造影 (GI)、纤维胃镜 (FG)及手术标本对照 ,明确螺旋CT(SCT)成像技术对溃疡型胃癌的诊断价值。资料与方法　经手术病理证实的 40例溃疡型胃癌行胃产气后SCT检查 ,其中 32例行胃气钡双重造影检查 ,2 6例有手术标本和胃镜录像。由 2位放射科医师对SCT及GI图像分别进行盲法阅读 ,评价病变的探测、Bor rmann分型及分析诊断可信度 ,阅片者间的一致度采用k检验。结果　 40例溃疡性病变手术病理共检出 49个病灶 ,2位阅片者SCT各检出 47个 ,32例GI检查者 ,病理证实 40个溃疡病灶 ,2位阅片者GI各明确检出 16和 15个溃疡病灶。BorrmannⅡ、Ⅲ型癌的鉴别CT仿真胃镜 (CTVG)准确性为 92 .39%,GI准确性为 2 6 .92 %(P <0 .0 5 )。结论　SCT对胃部溃疡性病灶的显示及Borrmann分型优于GI。Objective To evaluate spiral CT (SCT) scanning in the diagnosis of gastric ulcerative carcinoma by comparing it with upper gastrointestinal series (GI), fiberoptic gastroscopy and surgical findings. Materials and Methods After an effervescent agent was administered to the patient, SCT scanning was performed in 40 patients with pathologically confirmed gastric ulcerative lesions. Of the total 40 patients, double contrast GI was done in 32, gastroscopy and surgery in 26. Using blind method, GI films and SCT images, including axial scans, virtual gastroscopy, surface shaded display (SSD) and raysum, were viewed by two radiologists separately. The detection of the lesion, Borrmann's classification were evaluated. Inter observer's agreement was determined by using Kappa statistics.Results Total 49 ulcerative lesions were detected in 40 patients by surgery and pathology, of which 47 were detected on SCT by both observers. Total 40 ulcerative lesions were pathologically proved in 32 patients who underwent GI, of which the two observers separately found 16 and 15 on GI films. The classifying accuracy of Borrmann Ⅱ and Ⅲ was 92.39% and 26.92% for CT virtual gastroscopy and GI, respectively (P<0.05). Conclusion SCT is superior to GI in detecting gastric ulcerative lesions and in making Borrmann classification.

关 键 词：溃疡型胃癌 螺旋CT 诊断 钡餐 胃镜 比较研究 

分 类 号：R735.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]