超声双重造影在胃癌TNM分期上的诊断价值及局限性

Diagnostic value and limitation of double contrast-enhanced ultrasonography in gastric carcinoma TNM staging

目的探讨口服胃窗超声造影联合静脉超声造影(超声双重造影)在胃癌TNM分期诊断上的临床价值。方法对50例胃镜确诊胃癌患者进行超声双重造影检查并进行TNM分期,并与术后病理结果相比较分析。结果单纯口服胃窗超声造影对胃癌术前T分期的准确率为64.0%,其中T1、T2、T3、T4准确率分别为50.0%、53.3%、72.7%、66.6%。超声双重造影对胃癌术前T分期准确率达84.0%,其中T1、T2、T3、T4准确率分别为75.0%、80.0%、86.3%、88.8%。两者T分期准确率的差异有统计学意义(=0.023)。两者对淋巴转移者检出率不理想,且均低估胃癌的N分期。盆腔、肠系膜和大网膜种植远处转移等检出率较低。结论超声双重造影对胃癌T分期具有较高的临床应用价值,但对NM分期仍然有其局限性。

Objective To evaluate the diagnostic value of double contrast enhanced ultrasonography（DCUS,oral and intravenous contrast enhanced gastric ultrasonography） on preoperative TNM staging of gastric cancer.MethodsFifty pa-tients with gastric cancer proved by endoscopic biopsy who underwent preoperative DCUS examination were enrolled in this study,and the results were compared with postoperative pathologic findings.Results The detecting accuracy rare of oral gastric ultrasonography on T1,T2,T3 and T4 were 50.0%,53.3%,72.7% and 66.6%,respectively and the overall accuracy was 64.0%;staging rate was of DCUS in gastric cancer were 84.0%,with 75.0% of T1,86.6% of T2,86.3% of T3,88.8% of T4,and there was a significant difference（P 0.05）.It was not so good at detecting lymphatic metastasis for both ways and they underestimated N stage;moreover,they showed low distance metastasis detecting rates of pelvic cavity,mesentery and omentum majus.Conclusions DCUS is a useful diagnostic method for preoperative staging of gastric cancer.