128层螺旋CT在胃癌术前评估中的应用价值  

Application value of 128 slice spiral CT in preoperative evaluation of gastric cancer

作　　者：郑玉飞[1] 朱丽丽[1] 徐辉[2] 

机构地区：[1]江苏省句容市人民医院影像科,212400 [2]南京医科大学附属南京医院影像科

出　　处：《实用医技杂志》2017年第1期20-22,共3页Journal of Practical Medical Techniques

摘　　要：目的探讨128层螺旋CT在胃癌浆膜外侵犯及淋巴结、腹膜转移诊断中的应用价值。方法分析2013年1月至2015年10月间100例经胃镜病理证实的胃癌患者的CT影像资料,以手术及病理为对照,评价128层螺旋CT在胃癌浆膜外侵犯及淋巴结、腹膜转移方面的诊断价值。结果 100例胃癌患者,8例患者术前CT诊断为肝脏及腹膜转移未进行手术,其余92例患者行胃癌切除术。92例手术患者,对照手术病理,128层螺旋CT对胃癌浆膜外侵犯诊断的敏感性为75.0%,特异性为93.8%,与术后病理一致性较好(Kappa=0.64)。128层螺旋CT对92例胃癌N分期总体准确率为78.3%,与术后病理一致性满意(Kappa=0.76)。100例胃癌患者中,5例出现肝脏转移及1例腹膜转移CT均正确诊断,2例腹膜转移CT未能诊断,手术病理证实腹膜转移,128层螺旋CT对胃癌远处转移判断的准确率75.0%(6/8),与术后病理的一致性较好(Kappa=0.50)。结论 128层螺旋CT三期动态增强扫描及多平面重建能够较准确地评估胃癌浆膜外侵犯情况、淋巴结转移及腹膜转移情况,为临床治疗方案的选择提供帮助。Objective To explore the application value of 128 slice spiral CT in the diagnosis of gastric cancer and the diagnosis of lymph node and peritoneal metastasis. Methods The CT imaging of 100 patients between January2013 and October 2015 with gastric carcinoma confirmed by gastroscopy and pathology were analyzed. The diagnosis value of 128 slice spiral CT in the area of the external invasion and lymph node and peritoneal metastasis of gastric cancer was evaluated. Results One hundred cases of gastric cancer,8 cases of preo perative CT diagnosis of liver and peritoneal metastasis were not performed,and the remaining 92 patients underwent gastric cancer resection. Lighty-two cases of patients with surgery,the control operation pathology,128 slice spiral CT on the diagnosis of gastric cancer in the diagnosis of the sensitivity was 75.0%,specificity was 93.8%,which was in good agreement with the postoperative pathology（Kappa=0.64）. The overall accuracy rate of N staging in 92 cases of gastric cancer was 78.3%,which was consistent with postoperative pathology（Kappa=0.76）. One hundred cases of patients with gastric cancer,5 cases appeared liver metastasis and 1 cases of peritoneal metastases on CT were correctly diagnosed,2 cases of CT to the diagnosis of peritoneal metastasis,surgery and pathology confirmed peritoneal metastasis,128 slice spiral CT on gastric cancer distant metastasis judgment accuracy rate of 75.0%（6/8）,which was in good agreement with the postoperative pathology（Kappa=0.50）.Conclusion 128 slice spiral CT three phase dynamic enhanced scanning and multi planar reconstruction can be more accurate in the evaluation of gastric cancer,lymph node metastasis and peritoneal metastasis of gastric cancer,and provide help for the clinical treatment options.

关 键 词：体层摄影术 螺旋计算机 胃肿瘤 诊断 

分 类 号：R735.2[医药卫生—肿瘤]