64排增强CT对进展期胃癌根治程度的判断价值

Judgement Value of Preoperative MDCT on Radical Resection Extent for Advanced Gastric Cancer

目的探讨64排增强CT(MDCT)对进展期胃癌(AGC)手术根治程度的判断价值。方法分析70例AGC患者MDCT增强扫描的影像学资料,判断N2(第7、8和9组)淋巴结转移及脏器受侵情况,并将CT判断结果与手术后病理结果进行比较。结果62例患者接受手术治疗,8例因手术禁忌证无法行手术治疗。MDCT术前判定N2淋巴结转移的敏感性为92.0%(46/50),特异性为75.0%(9/12),准确性为88.7%(55/62)。MDCT术前判定存在N2或以上淋巴结转移者81.6%(40/49)行D2以上扩大根治术;判定N2淋巴结无转移者92.3%(12/13)行标准D2根治术。结论MDCT对诊断AGC N2淋巴结转移及周围脏器侵犯有重要价值,对AGC手术根治程度的判定有指导作用。

Objective To evaluate the role of preoperative 64 multi-detector spiral CT（MDCT） in predicting the extent of radical resection for advanced gastric cancer（AGC）.Methods The imaging data of 70 patients with AGC were collected and analyzed.The N2 lymph node metastasis was predicted by the MDCT indications,and compared with that postoperative pathological results.Results Sixty-two patients were treated with surgical intervention.The sensitivity,specificity,and accuracy of N2 positive prediction by MDCT was 92.0%（46/50）,75.0%（9/12） and 88.7%（55/62）,respectively.Extended resection was performed in 81.6%（40/49） patients who were predicted as N2 positive,and D2 resection was performed in 92.3%（12/13） patients who were predicted as N2 negative.Conclusion The MDCT is a valuable technique to predict N2 lymph node metastasis,and to determine the extent of resection for AGC.