64排螺旋CT对胃印戒细胞癌淋巴结转移的诊断价值

Evaluation of the Lymph Node Metastasis of the Gastric Signet Ring Cell Carcinoma by 64-row Spiral CT

目的:评价64排螺旋CT对胃印戒细胞癌淋巴结转移的诊断价值。方法:回顾性分析总结40例胃印戒细胞癌患者的CT平扫及三期动态增强扫描资料,并与手术病理结果对照。结果:本组病例术后淋巴结转移情况为N0期16例,N2期6例,N3期为11例,CT以淋巴结长径>6mm为阳性标准,发现N0期16例、N1期7例、N2期5例及N3期4例,其中CT各N分期特异性在76.5%～94.7%之间,但是对N2及N3分期的敏感性欠佳(分别为28.6%和33.3%)。转移淋巴结特点为静脉期和延迟期强化明显,虽高于动脉期强化,但是之间无统计学意义上的差异(P>0.05)。结论:64排螺旋CT对胃印戒细胞癌转移淋巴结的诊断及N分期有帮助,其诊断特异性较高,但是准确性和敏感性均有待提高。

To evaluate the lymph node metastasis of the gastric signet ring cell carcinoma by 64 -row Spiral CT. Methods：To review and analysis CT plain scan and three phase dynamic en- hancement imaging of 40 cases of gastric signet ring cell carcinoma, and compare with surgical pathol- ogy. Results：The surgical pathology of gastric signet ring cell carcinoma lymph node metastasis staging （ N staging） is 16 （ N0）, 6 （ N2）, 11 （ N3 ） respectively, and lymph nodes were considered to be in- volved by CT when the long axial diameter was 〉16 mm, the N staging of CT is 16 （NO） ,7 （N1） ,5 （N2） ,4（N3） respectively. The specificity of CT N staging is between 76.5% - 94. 7%, but the sensitivity of N2, N3 staging is not so good （28.6% and 33.3% respectively）, the CT characters of the lymph node metastasis is enhance obviously in venous and delay phase although CT value of venous and delay phase are higher than the arterial phase, but they were not statistically significant （P 〉 0. 05 ）. Condusions： 64 - row spiral CT can help to diagnosis and stage the lymph nodemetastasis of the gastric signet ring cell carcinoma, which has high specificity, but the sensitivity and accuracy of the N staging should be improved.