MSCT在胃癌术前诊断与临床TNM分期中的应用价值

Application of multi-slice CT in preoperative diagnosis and TNM staging of gastric carcinoma

目的利用64排螺旋CT前瞻性地对胃癌进行术前TNM分期,并与病理结果对照,确定CT在胃癌术前分期中的作用。方法经胃镜和组织病理学明确诊断证实的213例胃癌患者,于术前进行MSCT检查,所有患者空腹8 h后进行平扫和动态三期增强扫描,术前MSCT由3名资深放射科医生用双盲法进行TNM分期,评定时根据需要进行多平面容积重组并与术后病理学诊断进行对照。结果 213例胃癌患者MSCT的T、N、M分期总体判断准确率分别为80.3%、72.3%、84.4%。MSCT对于胃癌TNM判断的总体准确率为82.2%。进展期胃癌检出率为96.4%(187/194),早期胃癌检出率为73.1%(19/26)。结论 MSCT动态三期增强扫描对胃癌术前诊断及TNM分期有重要价值。

Objective To evaluate the application of 64 multi-slice spiral CT（ MSCT） in preoperative diagnosis and TNM staging of gastric carcinoma. Methods MSCT examinations w ere performed in 213 patients w ith gastric carcinoma diagnosed by gastrointestinal endoscopy and pathology prior to operation,all of them subsequently underw ent surgery. MSCT findings w ere assessed by three senior radiologists separately before surgery,and the imaging results w ere compared w ith pathological findings postoperatively. Results With histopathological results as gold standard,the accuracy rate for T staging,N staging and M staging assessed by MSCT w as 80. 3%,72. 3 % and 84. 4%,respectively. The overall accuracy rate for TNM staging by MSCT w as 82. 2%（ 175 /213）. The detection rate of gastric carcinoma in advanced and early stages w ere 96. 4%（ 187 /194） and 73. 1%（ 19 /26）, respectively. Conclusion Dynamic enhanced MSCT scan is of high value in preoperative diagnosis and TNM staging of gastric carcinoma.