CT仿真胃镜与钡餐比较评价进展期胃癌分型

Evaluation Macromorphy of Advanced Gastric Carcinoma CT Virtual Gastroscopy Combined with Section Imaging: Comparison with Conventional Barium Study

目的:比较评价CT仿真胃镜(CTVG)及其结合横断面图像、上消化道造影(UGI)对进展期胃癌分型的鉴别价值。方法:经手术证实为进展期胃癌患者40例,所有患者均在3天内行以气体为对比剂的螺旋CT及UGI检查,2位阅片者对所有的CT图像及UGI图像进行主观性盲法阅片。结果:对于局限型(BorrmannⅠ、Ⅱ型)与浸润型(BorrmannⅢ、Ⅳ型)胃癌分型鉴别的准确性,CTVG明显优于钡餐,结合横断面图像后可以提高分型的准确率。结论:CTVG对进展期胃癌分型的鉴别优于UGI,评价CTVG应结合横断面图像。

Objective: To compare CT virtual gastroscopy(CTVG) combined with section image with upper gastrointestinal series (UGI) for accuracy in differentiation between circumscribed and infiltrative macroscopic types of advanced gastric carcinoma. Methods: 40 histologically proven advanced gastric cancer patients underwent both spiral CT and UGI imaging studies within 3 days. All CTVG, section and UGI images were assessed by two independent observers by using a five-point scale for the differentiation between circumscribed type(Borrmann's type1 and type 2) and infiltrative type(Borrmann's type3 and type4). Receiver operating characteristic(ROC) curves for CTVG, CTVG combined with section, and UGI imaging were analyzed. Results: CTVG was superior to UGI in differentiation between circumscribed and infiltrative macroscopic types, and combined with section image could improve the accuracy. Conclusion: CTVG is more sensitive than UGI imaging in differentiation between circumscribed and infiltrative macroscopic types of advanced gastric carcinoma, and CTVG should be combined with section image when being interpreted.