64排多层螺旋CT在胃癌病灶检测和术前肿瘤分期中的作用

The value of 64-channel MSCT in detecting and preoperative tumor staging of gastric cancers

目的通过与手术病理结果比较,回顾性分析64排多层螺旋CT(multi-slice CT,MSCT)检测胃癌病灶的能力和在术前肿瘤分期中的作用。方法对105例经手术病理证实的胃癌患者的CT平扫和双期增强扫描的资料进行分析,评价轴位CT图像、多平面重组(multiplanar reconstruction,MPR)和MPR结合CT胃镜(CT gastrosco-py,CTG)检出胃癌病灶的准确率以及轴位CT图像和MPR对胃癌T分期的准确率。结果轴位CT图像、MPR和MPR结合CTG检测胃癌病灶的准确率分别为84.76%、91.43%和95.24%,轴位CT图像与MPR以及MPR与MPR结合CTG之间的检出率无显著性差异(P>0.05),但轴位CT与MPR结合CTG检出胃癌病灶的准确率有显著性差异(χ2=6.40,P<0.05)。轴位CT图像与MPR对胃癌肿瘤分期的准确率分别为76.40%和87.50%,两者有显著性的差异(χ2=3.88,P<0.05)。结论与轴位CT图像相比,MPR结合CTG显著提高胃癌病灶的检出率,MPR可明显提高胃癌肿瘤分期的准确率。

Objective To assess the role of MSCT in detecting and preoperative tumor staging of gastric cancers with pathologic and surgical results as the reference standard. Methods 105 patients with gastric cancers confirmed by surgery underwent CT scans. Compared with axial CT images and histopathology, the accuracy of multiplanar reconstruction and CT gastroseopy for detecting and staging of gastric cancers was evaluated. Results The overall accuracy of axial images, MPR and MPR combined with CT gastroscopy for the detection of gastric lesions was 84. 76% , 91.43% and 95. 240/0 , re- spectively. No statistically significant difference was noted between axial images and MPR, and between MPR and MPR combined with CTC （P 〉 0. 05）. But there was statistically significant difference between the axial images and MPR com- bined with CTC （P 〈 0. 05）. The accuracy of tumor staging was 76. 40% （68/89） for axial CT images, and 87.50% （84/96） for MPR （X^2 = 3.88, P 〈 0. 05）. Conclusion Compared with axial CT images, MSCT gastrography with MPR and CT gastroscopy can improve the accuracy of lesion detection and preoperative tumor staging of gastric cancers. The difference was significant for tumor staging.