术前超声双重造影检查对胃癌患者胃周淋巴结转移的评估价值

Double contrast-enhanced ultrasonography in preoperative assessment of lymph node metastasis of gastric cancer

目的探讨超声双重造影检查（DCUS）在不同部位胃癌术前淋巴结转移评估中的应用价值。方法选择180例胃癌患者，手术前3～5d内均进行DCUS及螺旋CT检查，对不同部位的胃癌患者术前均进行淋巴结分站评估，与术后病理检查结果对照得出正确率，并进行相互间比较。结果DCUS和螺旋CT检查对远端胃切除患者淋巴结转移判断正确率分别为86．0％和83.9％，对全胃切除患者的判断正确率分别为82.5％和85.0％，两种检查方法判断准确率差异均无统计学意义（P〉0．05）；DCUS对近端胃切除患者淋巴结转移判断正确率为66．0％，明显低于螺旋CT检查的85．1％，差异有统计学意义（均P〈0．05）。结论胃癌术前淋巴结转移评价中，超声双重造影检查判断正确率与螺旋CT相当，仅对贲门胃底部癌判断正确率略低。

Objective To evaluate the application of double contrast enhanced ultrasound （DCUS） in preoperative as- sessment of lymph node metastasis of gastric cancer. Methods One hundred and eighty patients with gastric cancer, who un- derwent surgical resection as primary management were included in the study. DCUS and spiral CT examinations were per- formed in all patients 3-5d before surgical intervention. The diagnostic accuracy of ultrasound and CT findings was analyzed with pathological results of resected lymph nodes as gold standard. Results The accuracy rate for lymph node metastasis of DCUS and spiral CT was 86.0% and 83.9% in gastric antrum and pyloric carcinoma, respectively（P 〉0.05）; that was 82.5% and 85.0% in overall gastric cancer or tumors located in stomach body, respectively（P 〉0.05）. However the diagnostic accuracy rate for lymph node metastasis of DCUS was lower than that of spiral CT in cardia or fundus gastric carcinoma （66.0% ,85.1%, P〈0.05）. Conclusion Double contrast-enhanced ultrasonography offers a high overall accuracy in preoperative lymph node evaluation of gastric cancer, which is similar to that of spiral CT, except for cardia or fundus gastric carcinoma.