胃低张充气64层螺旋CT三期增强扫描对胃癌术前TNM分期的临床价值

The values of 64 multi-slice spiral CT triphasic dynamic scanning with hypotonicity and gas to the preoperative staging of gastric carcinoma

目的探讨低张充气64层螺旋CT三期增强扫描对胃癌术前TNM分期的应用价值。方法回顾性分析经术后病理和(或)胃镜活检证实的50例胃癌患者术前一周行低张充气64层螺旋CT三期增强扫描后的TNM分期,并与病理结果相对照。结果 50例患者胃壁浸润深度的T1-T4分期结果准确性分别为66.7%、75.0%、76.9%、75.0%,总准确性为74.0%,淋巴结N0-2转移的准确性分别为68.8%、54.5%、66.7%,远处转移的M0和M1的准确性分别为100%和85.7%,与手术病理对照一致性良好。结论低张充气64层螺旋CT三期增强扫描对胃癌术前TNM分期与术后病理具有良好的相关性,可以更好的指导临床医生对胃癌的术前判断,缩短手术时间,提高手术成功率。

Objective To explore the application values of multi-slice spiral CT triphasic dynamic scanning with hypotonicity and gas to the preoperative staging of gastric carcinoma.Methods Fifty patients with gastric carcinoma proven by biopsy underwent MSCT examination one week before the operation or gastroscope.Triphasic（arterial-dominant phase,portal venous-dominant phase and venous-dominant phase） incremental scanning by multi-slice spiral CT was performed after plain scanning.TNM staging criteria were applied according to AJCC classification.The results were compared with surgical pathological findings.Results The accuracy rates of T1-4 clinical stage determined with multi-slice spiral CT were 66.7%、75.0%、76.9%、75.0%,respectively.The unitary accuracy was 74.0%.The accuracy rates of N0-2 were 68.8 %、54.5%、66.7%,respectively.The accuracy rates of M0-1 were 100% and 85.7%,respectively.It showed accordance tendency between the preoperative TNM stages and surgical pathological findings.Conclusion Triphasic incremental scanning by multi-slice spiral CT with hypotonicity and gas has a great clinical value to the preoperative TNM staging and assessment of gastric carcinoma.It can acquaint the Clinician with the gastric carcinoma before the operation and increase the success rate of the operation.