螺旋CT对进行期胃癌大体类型及局部侵袭范围的研究

Judgement of gross type and local invasion of advanced gastric carcinoma by spiral computed tomography

目的 评价螺旋CT对进行期胃癌大体类型、浆膜及邻近器官受侵判断的临床应用价值。方法 对全胃或部分胃切除术的进行期胃癌 5 3例进行螺旋CT诊断 ,并与手术病理结果对照。结果 螺旋CT对胃癌大体类型、部位、大小判断准确率分别为 92 .5 %、88.7%和 81 1%。以胃外脂肪征象判断浆膜受侵准确率为 80 .5 % ,以CT浆膜轮廓征象判断浆膜受侵的准确率为 6 3.4% ,二者差异有显著性 (P <0 .0 5 )。通过螺旋CT征象可大致区分浆膜类型。螺旋CT对胰腺、脾脏、横结肠受侵判断准确率分别为 87.8%、87.8%和 90 .2 % ,特异性分别为 96 .7%、97.0 %和 96 .7%。结论 螺旋CT在胃癌大体类型、肿物大小、部位的判断上有较高的准确率 ;螺旋CT胃外脂肪间隙征象是判断浆膜侵出的较准确标准 ;

Objective To evaluate the value of spiral computed tomography(sCT) in the judgement of gross type, invasion to serosa and adjacent organs of advanced gastric carcinoma. Methods The sCT results of 53 cases of advanced gastric carcinoma undergone gastrectomy were compared with surgical pathologic findings.Results The accuracy of judging gross type, location and size of gastric carcinoma was 92.5%, 88.7%, 81.1% respectively;80.5% of serosal invasion was correctly judged by extraluminal fat sign, while 63.4% by serosal contour sign ( P <0.05). Different serosal types could be differentiated by CT features. The accuracy of judging invasion to pancreas, spleen and transverse colon was 87.8%, 87.8%, and 90.2%; and the specificity was 96.7%, 97.0% and 96.7%, respectively.Conclusion Spiral computed tomography is of help in the identification of the gross type, invasion to serosa and adjacent organs of gastric cancer in its stage of progression.