谐波成像技术与胃窗造影在胃癌定量诊断中的应用

The clinical application of tissue hanrmonic-imaging technique in gastric carcinoma diagnosis

目的研究组织谐波成像技术(THI)与胃窗造影在胃癌显像中对图像质量改善的影响以及在胃癌定量诊断中的应用价值。方法对120例胃癌患者分别采用基波成像(FI)和组织谐波成像,并与手术病理结果对照。结果24例FI成像质量满意的图像THI与FI显示了良好的一致性(P>0.05);96例FI成像图像质量不满意者在THI状态下69例得到明显改善,平均改善率为71.9%,二者差异有统计学意义(P<0.05)。在胃癌定量分析中,对病灶范围小于2cm和5cm以下测值的符合率较高,分别为85.7和82.5%;>5cm以上的测值误差范围较大,符合率仅为61.8%;对浸润深度判定与手术病理结果对照,早、中、晚各期符合率分别为66.7%、75.0%和93.3%;超声对胃外脏器转移的检出率为100%,而对单纯淋巴结转移的的检出率仅为61.7%。结论THI技术对小病灶范围测值与手术结果有良好的一致性,对胃癌术前分期判断准确性较高,能为临床术前预测肿瘤可切除性提供较为可靠的量化指标。

Objective To study the influence of tissue hanrmonic - imaging technique （THI） on improvement of imagine quality, and the value of clinical application to quantitative diagnosis of gastric carcinoma. Methods The fundamental wave （FI） and THI were used to 120 gastric carcinoma cases, respectively; making a flexible change to THI if any cases who are not suitable to FI,0bserving the influence of THI through image quality. Result The good image of 24 cases by FI show a well consistent with THIs （ P 〉0. 05 ）. 69 cases have a significant improvement by THI among 96cases by FI（71.9% ） （P 〈0.05）. For node size 2cm and 5cm,the coincident rate are 85.7 and 82.5%, error range is very small, While for 〉 5cm was only 61.8% in gastric carcinoma quantitative analysis. Compare determination of encroach depth with result of biopsy, the coincident rate for the earlier period, metaphase and advanced stage are 66. 7%, 75.0% and 93.3%. Wether infiltration or aversion to adjoin organ is 100%. but the coincident rate for simple lymph node aversion only 61.7% by ultrasound;Conclusions THI could improve image quality significantly and show a perfectly consistent with operational result for small node size; it displays higher accuracy to typing the gastric carcinoma before operation. THI can be regarded as a basic technique to diagnostic tool, which will be the fundamental guideline for treatment.