MDCT联合多平面重建技术在胃癌术前T、N分期中的应用研究

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

目的：利用16排螺旋CT以及多平面重建（multiplanar reconstruction，MPR）后处理技术对胃癌进行术前T、N分期并与病理相对照，比较横断面和MPR在胃癌术前T、N分期中的作用。方法经胃镜证实的71例患者，术前采用16排螺旋CT平扫和双期增强扫描，由2位资深放射科医师对横断面图像及重建出的MPR图像中的肿瘤进行定位及T、N分期，并与病理结果对照。结果横断面与MPR图像对胃癌的检出率分别为90.1%和97.2%，其中MPR对进展期胃癌的检出率为100%。横断面与MPR图像的术前T分期总体准确率分别为59.2%和73.2%，差异具有统计学意义；两种方法的术前N分期总体准确率分别为78.9%和83.1%。结论和横断面相比，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。

Objective To assess the effect 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 71 patients of gastric carcinoma diagnosed by biopsy prior to operation. All patients were scanned on 16-detectors row CT including plain scan and dual-phase enhanced scans respectively. Then arterial and venous phase MPR images were reconstructed according to raw data. The site and local staging of gastric carcinoma in routine cross-sectional images and MPR images were prospectively analyzed by two doctors conjunctly and correlated with pathological ifndings in surgery. Results The detection rate of gastric carcinoma by cross-sectional images and MPR images was 90.1%and 97.2%respectively. The detection rate of advanced gastric carcinoma by MPR im-ages was 100%. The accuracy for T staging detected by cross-sectional images and MPR images was 59.2%and 73.2%respectively. MPR images were superior to transverse images. The accuracy for N staging was 78.9%and 83.1%respectively for two different images. Conclusion The MPR images can improve detection rate and local staging of gastric carcinoma compared with routine cross-sectional images.