16排CT三维成像在胃癌诊断中的临床应用

Clinical Application of 16 Slice CT Three-Dimensional Imaging in Diagnosis of Gastric Carcinoma

目的：研究16排螺旋CT三维成像（3DCT）包括表面遮盖法（SSD）、仿真胃镜（CTVG）在胃癌诊断中的价值。方法：123例胃癌患者（121例进展期胃癌，2例早期胃癌）均经胃镜活检病理证实，121例手术证实（2例进展期胃癌伴肝转移而未能手术）。使用GE Lightspeed Ultra16排CT行全胃扫描，扫描条件层厚1．25mm，1．375：1，0．8s／r，120kV，300mA，扫描总时间6～8S。对123例胃癌用2种常用的成像方法检查，评价图像质量、病变检出率、Borrmann分型等，并与胃镜和手术结果比较。结果：16排CT的SSD和CTVG的图像质量均显示满意；SSD和CTVG的病变检出率分别为93．50％（115／123）、94．31％（116／123）；进展期胃癌Borrmann分型的敏感度均为95．04％（115／121）。16排CT扫描克服了腹部呼吸运动伪影的影响，明显提高了三维图像质量。结论：16排CT三维成像大幅提高了图像质量和病变检出能力，为胃癌的术前准确评价提供了可信依据。

Objective：To assess the value of 16 slice CT three-dimensional imaging （3D CT） including surface shaded display （SSD） and CT virtual gastroscopy （CTVG）compared with gastroscopy and operational outcome. Methods： 123 gastric carcinoma patients （121 advanced gastric carcinomas and 2 early gastric carcinomas ） were proved histologically with gastroscopy,among these, 121 cases proved by operation. Using GE Lightspeed Ultra 16 slice CT to perform whole stomach scan, scanning condition： 1.25 mm, 1. 375： 1,0. 8 s/rot, 120 kV, 300 mA, scan total time 6～8 s. We evaluated all 123 patients with two imaging techniques in terms of image quality, lesion detective rate, Borrmann classification, and compared them with gastroscopy and operational outcome. Results：Image quality of SSD and CTVG in 16 slice CT was satisfactory. Lesion detective rates of SSD and CTVG were 93.50～（ 115/123 ） and 94.31% （ 116/123 ）, respectively; Borrmann classification sensitivity of advanced gastric carcinoma was all 95.04% （115/121 ）. Thin-slice and high-speed character of 16 slice CT overcame abdominal respiratory movement artifacts and apparently improved 3D image quality. Conclusion.. 16 slice CT three-dimensional imaging obviously improves image quality and lesion detection ability,and provides reliable basis for more exact preoperational evaluation of gastric carcinoma.