仿真胃镜与钡餐比较评价胃部溃疡性病灶:ROC曲线分析  

Comparison between CT virtual gastroscopy and barium examination in evaluation of gastric lesion:ROC curve analysis

作　　者：孙军[1] 郑凯尔[1] 陈峰[1] 居胜红[1] 欧希龙[2] 胡征江[1] 

机构地区：[1]东南大学附属中大医院放射科,南京210009 [2]东南大学附属中大医院消化科,南京210009

出　　处：《放射学实践》2003年第4期233-236,共4页Radiologic Practice

基　　金：ECR 2 0 0 0:EAR ECR Research and Education Fund Fellowship Grant;江苏省卫生厅重点资助课题 (H 992 81)

摘　　要：目的 :与上消化道钡餐 (UGI)比较研究CT仿真胃镜 (CTVG)对胃部溃疡性病变诊断的价值。方法 :经胃镜证实为溃疡性病变的患者 39例 ,手术病理证实 2 9例为胃癌 ,1 0例为良性溃疡。所有患者均在 3天内行螺旋CT及UGI检查 ,两位阅片者对所有的CTVG及UGI图像进行主观性盲法阅片。图像质量的评价分 3级 ,检出的可信度、良恶性溃疡的鉴别及恶性溃疡分型的鉴别评价分 5级 ,后两项采用ROC曲线进行分析。结果 :两位阅片者均认为对于图像质量、病灶检出率、溃疡病灶的良恶性鉴别 ,CTVG与UGI类似 (P >0 .0 5) ;对于溃疡型胃癌分型的准确性 ,CTVG明显优于钡餐 (P <0 .0 5)。结论 :CTVG对溃疡型胃癌分型的判断优于UGI,但对溃疡病灶的良恶性鉴别 ,CTVG与UGI无明显差异 ;胃部螺旋CT扫描是一种简便、有效的检查方法 。Objective:To compare CT virtual gastroscopy (CTVG) with upper gastrointestinal series (UGI) for accuracy in differentiation between benign and malignant ulcer and for accuracy in differentiation between Borrmann′s type Ⅱ and type Ⅲ of malignant ulcer.Methods:Thirty nine patients (23 men,16 women,aged 27～70 years) observed of having gastric ulcerous lesions by conventional gastroscopy were examined.The final diagnosis was confirmed at surgery to be gastric cancer in 29 patients;the other 10 patients were deemed to have gastric benign ulcer.All patients underwent both spiral CT and UGI imaging studies within 3 days.All CTVG and UGI images were assessed by two independent observers by using a three point scale for image quality and a five point scale for the detection of lesion,the differentiation between benign and malignant ulcer and the differentiation between Borrmann′s type Ⅱ and type Ⅲ of malignant ulcer.Receiver operating characteristic curves for CTVG and UGI imaging were analyzed.Results:At image quality,detection of lesion and differen tiation between benign and malignant ulcer analysis,CTVG and UGI imaging were comparable,but CTVG was superior to UGI imaging ( P <0.05) in differentiation between Borrmann′s type Ⅱ and type Ⅲ of malignant ulcer.Conclusion:CTVG is more sensitive than UGI imaging for differentiation between Borrmann′s type Ⅱ and type Ⅲ of malignant ulcer.

关 键 词：胃部溃疡性病变 诊断 上消化道钡餐 CT仿真胃镜 比较 

分 类 号：R573.1[医药卫生—消化系统]