MDCT多平面重建技术在胃癌术前T、N分期中的应用

The Study of Multiplanar Reconstruction of MDCT in T and N Staging of Gastric Carcinoma

目的:利用16排螺旋CT多平面重建(MPR)后处理技术对胃癌进行术前T、N分期并与病理相对照,确定MPR后处理技术在胃癌术前T、N分期中的作用。方法:经胃镜证实的70例患者,术前采用16排螺旋CT平扫和动脉期、门静脉期双期增强扫描,由两位资深放射科医师对常规5mm层厚横断面图像及重建出的薄层MPR图像中的肿瘤进行定位及T、N分期,并与病理结果对照。结果:常规5mm层厚横断面与MPR图像对胃癌的检出率分别为88.6%和195.7%,其中MPR图像对进展期胃癌的检出率为100%。常规5mm层厚横断面与MPR图像的术前T分期总体准确率分别为60%和74.3%,差异具有显著性意义;两种方法的术前N分期总体准确率分别为78.6%和81.4%,MPR图像术前N分期的敏感性提高至98.1%,特异性降低至72.2%。结论:和常规横断面相比,采用MPR后处理技术能提高病变的检出率,又能提高病变的T、N分期。

Pnepose： To assess the Value of multiplanar reconstruction （MPR） of dynamic multi-detector row CT （MDCT） in the preoperative T and N staging of gastric carcinoma. Methods： MDCT was performed in 70 patients with gastric carcinoma diagnosed by biopsy prior to operation. All patients were scanned on a 16-detector row CT including plain scan and dual-phase enhanced scans respectively, then thin arterial and venous phase multiplanar reconstruction images were reconstructed according to the raw data. The location and staging of gastric carcinoma on routine 5mm cross-sectional images and MPR images were prospectively analyzed by two doctors, and the results were correlated with the pathological findings after surgery. Re- sults： The detection rate of gastric carcinoma by 5mm cross-sectional images and MPR images was 88.6% and 95.7% respectively. The detection rate of advanced gastric carcinoma by MPR images was 100%. The accuracy for T staging detected by 5mm cross-sectional images and MPR images was 60% and 74.3% respectively. MPR images were superior to transverse images. The accuracy for N staging was 78.6% and 81.4% respectively for two different kinds of images. The sensitivity and specificity for N staging was 98.1% and 72.2% respectively. Conclusion： The MPR images can improve the detection rate and staging of gastric carcinoma when compared with routine 5mm cross-sectional images.