多层螺旋CT联合钡餐造影诊断胃癌的临床应用价值  

Clinical application of barium meal contrast combined with multi-slice spiral CT in the diagnosis of gastric cancer

作　　者：周倩倩 朱从山 吴冬春 ZHOU Qianqian;ZHU Congshan;WU Dongchun(Department of Imaging Center,Tongcheng People's Hospital,Anqing 231400,China)

机构地区：[1]安徽省桐城市人民医院影像中心,安徽安庆231400

出　　处：《医学影像学杂志》2024年第12期95-98,共4页Journal of Medical Imaging

基　　金：安徽省重点研究与开发计划项目(编号:201904a07020006)。

摘　　要：目的探讨多层螺旋CT(MSCT)联合钡餐造影检查诊断胃癌的临床价值。方法选取疑似胃癌的96例患者,均接受钡餐造影和MSCT检查,检查结束后7 d内接受胃镜活检。通过受试者ROC曲线分析诊断结果一致性。结果经胃镜活检96例高度疑似胃癌患者中胃癌85例,其中T1期13例、cT2期27例、cT3期34例、cT4期11例;非胃癌11例。胃癌患者峰值强化(PEI)、表面通透性(PS)高于非胃癌患者,胃部黏膜不连续、龛影、充盈缺损占比显著高于非胃癌患者,差异有统计学意义(P<0.05)。绘制ROC曲线显示,MSCT(PEI、PS)、钡餐造影(胃部黏膜不连续、龛影、充盈缺损)单独及联合诊断胃癌的曲线下面积(AUC)值分别为0.712、0.704、0.690、0.718、0.674、0.908,联合诊断价值最高。钡餐造影、MSCT单独及联合评估胃癌分期与金标准结果的一致性Kappa值分别为0.658、0.782、0.881,联合评估一致性最高。钡餐造影联合MSCT评估胃癌分期的准确率显著高于钡餐造影、MSCT单独评估,差异有统计学意义(χ^(2)=7.531,P=0.023)。结论MSCT与钡餐造影联合诊断可为胃癌临床分期评估提供影像学参考。Objective To explore the diagnostic value of barium meal contrast combined with multi-slice spiral CT(MSCT)for gastric cancer.Method 96 patients suspected of gastric cancer were selected and underwent barium meal imaging and MSCT examination.Within 7 days after the examination,gastroscopy biopsy was performed.we analyzed the value of barium meal contrast combined with MSCT in the qualitative and staging diagnosis of gastric cancer through receiver operating characteristic curve(ROC)analysis,consistency analysis,and other methods.Result Through gastroscopy biopsy,85 out of 96 highly suspected gastric cancer patients had gastric cancer,including 13 stage T1,27 in stage cT2,34 in stage cT3,and 11 in stage cT4;11 cases were non gastric cancer.The peak enhancement(PEI)and surface permeability(PS)of gastric cancer patients were higher than those of non gastric cancer patients,and the proportion of gastric mucosal discontinuity,niche,and filling defects was significantly higher than that of non gastric cancer patients,with statistical significance(P<0.05).The ROC curve showed that the area under the curve(AUC)values of MSCT(PEI,PS)and barium meal imaging(gastric mucosal discontinuity,niche,filling defect)alone and in combination for the diagnosis of gastric cancer are 0.712,0.704,0.690,0.718,0.674,and 0.908,respectively,with the highest value for combined diagnosis.The Kappa values for the consistency between barium meal imaging,MSCT alone,and combined evaluation of gastric cancer staging and the gold standard results were 0.658,0.782,and 0.881,respectively,with the highest consistency observed in combined evaluation.The accuracy of barium meal imaging combined with MSCT in evaluating gastric cancer staging was significantly higher than that of barium meal imaging and MSCT alone,and the difference was statistically significant(χ^(2)=7.531,P=0.023).Conclusion Barium meal contrast combined with MSCT can provide imaging reference for clinical staging evaluation of gastric cancer diagnosis.

关 键 词：胃癌 钡餐造影 体层摄影术 X线计算机 

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