CT三维重建对胃癌术后复发的诊断意义

Diagnostic Significance of CT Three Dimension Reconstruction in Local Recurrence after Surgery for Gastric Cancer

目的探讨CT三维重建技术对胃癌术后复发的诊断意义。方法对哈尔滨医科大学附属第三医院2004年12月至2008年12月期间经手术或临床证实的39例胃癌根治术后复发的患者行多层螺旋CT扫描,在工作站进行三维重建,用CT轴位图像和三维后处理图像分别对胃癌术后复发患者进行诊断。结果 CT轴位图像和三维后处理图像对病变形态、侵犯范围、淋巴结转移及远处转移情况的检出率分别为82.1%(23/28)和100%(28/28),62.5%(10/16)和93.8%(15/16),66.7%(10/15)和93.3%(14/15),87.5%(7/8)和87.5%(7/8)。结论 CT三维重建对于增厚胃壁垂直厚度的测量、周围组织的浸润情况的观察及对淋巴结整体形态的变化可更直观、立体地进行诊断,对于胃癌术后复发的诊断优于单纯轴位图像,为复发肿瘤进一步治疗提供资料。

Objective To discussion the diagnostic significance of CT three dimension reconstruction in local recurrence after surgery for gastric cancer. Methods Thirty-nine patients with gastric cancer recurrence after radical surgery were performed multislice CT scan between December 2004 and December 2008 in The Third Affiliated Hospital of Harbin Medical University,and the images were reconstructed by three dimension reconstruction in workstation. The axial CT images and three dimension images of gastric cancer recurrence patients were diagnosed and compared. Results The detection rates of axial images and three dimensional CT images were 82.1% （23/28） and 100% （28/28） for pathological morphology,62.5% （10/16） and 93.8%（15/16） for extension of tumors,66.7% （10/15） and 93.3% （14/15） for lymph node metastasis,87.5% （7/8） and 87.5% （7/8） for distant metastasis,respectively. Conclusions CT three dimension reconstruction can carry out more direct and solid results,such as measuring the vertical thickness of the thickened gastric wall,observing the infiltration situation with proximal organ,and metastasis of the lymph node. The method of three dimension reconstruction used for the diagnosis of local recurrence after surgery for gastric cancer is better than the axial image,and it can supply data which would be useful for the tumor advancing treatment.