分析多层螺旋CT三维重建对胃癌术前分期的价值  

The Value of Three-dimensional Reconstruction of Multi-slice Spiral CT in Preoperative Staging of Gastric Carcinoma

作　　者：刘宇[1] 胡君 LIU Yu;HU Jun(Department of Radiology,Hubei Provincial Hospital of Traditional Chinese Medical,Wuhan Hubei 430063,Chin)

机构地区：[1]湖北省中医院放射科,湖北武汉430063

出　　处：《中国卫生标准管理》2018年第11期129-131,共3页China Health Standard Management

摘　　要：目的研究分析多层螺旋CT三维重建对胃癌术前分期的价值。方法回顾我院2017年1月—2018年1月收治的70例经术前胃镜和病理检查确诊的胃癌患者病历资料。患者均进行术前多层螺旋CT平扫和双期增强扫描,分析多层螺旋CT横断位和多平面重建图像,计算出多层螺旋CT横断位和多平面重建图像的胃癌检出率,以及T分期准确率和N分期准确率。结果 (1)70例胃癌患者的术后病理诊断结果,10例是早期胃癌,58例是进展期胃癌,2例没有采用手术治疗。CT诊断的进展期胃癌均为T4期,多层螺旋CT横断位图像检出了63例肿瘤,检出率为90%,多平面重建图像检出了66例肿瘤,检出率为94.29%。漏诊的均是早期胃癌,其中多平面重建图像多检出了3例早期胃癌。(2)依据多层螺旋CT图像的T分期准确的例数有57例,占83.8%,多平面重建图像横断位图像检出了44例,占64.7%,两者检出率比较,χ2=10.285,P<0.05,差异有统计学意义。结论多层螺旋CT横断位和多图像三维重建可以观察出肿瘤的大小、形态和邻近结构,可以进行良好精准的术前分期,是胃癌治疗依据的不二选择。Objective To study and analyze the value of threedimensional of multi-slice spiral CT in preoperative staging of gastric carcinoma. Methods The medical records of 70 patients with gastric cancer confirmed by preoperative gastroscopy and pathological examination were retrospectively reviewed in our hospital from January 2017 to January 2018. All patients underwent preoperative spiral CT and two-stage enhanced scanning, analyzed the transverse and multi-planar reconstruction images of multi-slice spiral CT, computed the detection rate of gastric cancer in transverse and multiplanar reconstruction images of multi-slice spiral CT, and the accuracy of T staging and the accuracy of N staging. Results（1） 70 patients with gastric cancer had postoperative pathological diagnosis, 10 cases were early gastric cancer, 58 cases were advanced gastric cancer, and 2 cases did not use surgical treatment. CT diagnosis of advanced gastric cancer was T4 period, the transverse image of multi-slice spiral CT detected 63 cases of tumor, detection rate was 90%, multi-planar reconstruction image of 66 cases of tumor, detection rate was 94.29%. All the missed diagnoses were early gastric cancer, in which 3 cases of early gastric cancer were detected by multi-planar reconstruction images.（2） According to the T-staging of multi-slice spiral CT images, there were 57 cases, accounting for 83.8%, the transverse image of multiplanar reconstructed image was detected in 44 cases, accounting for 64.7%, χ^2=10.285, P〈0.05. Conclusion The transverse and multiple images of multi-slice spiral CT can be used to observe the size, shape and adjacent structure of the tumor, and it is the best choice for the treatment of gastric cancer.

关 键 词：多层螺旋CT 三维重建 胃癌术前分期 诊断 价值 治疗依据 

分 类 号：R445[医药卫生—影像医学与核医学]