多层螺旋CT对胃癌的诊断及T分期价值探讨

Evaluation of multi-slice spiral CT in diagnosis and T staging of gastric carcinoma

目的:评价多层螺旋CT平扫及三期增强扫描在胃癌诊断和T分期中的价值,探讨胃癌的CT征象与其手术病理结果的关系。方法:搜集90例经胃镜证实为胃癌的患者资料,均于术前1周内行多层螺旋CT检查,并将检查结果与术后病理结果对照分析。结果:MSCT能够显示粘膜和粘膜下层、肌层、浆膜层的侵犯程度,判断浆膜层受侵的准确率为73%。对胃癌T1期、T2期、T3期、T4期的准确率分别为33.3%、42.9%、66.7%、85.2%,T分期总体准确率为62.2%。结论:MSCT常规平扫加三期增强扫描及多种图像处理技术,能够准确地对胃癌作出诊断,并提高T分期的准确性,是胃癌术前分期的可靠方法,有利于临床制订合理的手术方式和治疗方案。

Objective：To evaluate the value of plain and triple-phase enhanced MSCT in the diagnosis and preoperative T staging of the gastric carcinoma,and to discuss the relationship between CT image signs and pathologic findings.Methods：90 consecutive patients with endoscopic confirmed gastric carcinoma were preoperatively evaluated with MSCT.All patients subsequently underwent surgery. Operative findings and pathological diagnosis were correlated with that of MSCT findings.Results：MSCT could show involvement status of mucosa,submucosa,muscle and serosa.The accuracy for judging serosa was 73%.The accuracies of MSCT for the T1 staging,the T2 staging,the T3 staging,and the T4 staging of the gastric carcinoma were 33.3%,42.9%,66.7%,and 85.2%,respectively.The overall accuracy of MSCT for judging T staging was 62.2%.Conclusion：The plain and triphase enhanced scans of MSCT are helpful for the diagnosis of gastric carcinoma and the T staging,which is useful for the selection of the operative project and the therapy plan.