MSCT多期扫描及图像后处理在胃癌诊断中的应用

Application of multislice spiral CT multistage scan and post-processing techniques in diagnosis of gastric carcinoma

目的探讨多层螺旋CT(multislice spiral computed tomography,MSCT)多期扫描及图像后处理对胃癌的诊断价值。方法收集经病理证实的胃癌患者25例,术前行MSCT平扫、三期动态增强扫描及三维重建扫描,再运用多平面重建、容积重建及CT仿真内窥镜等后处理技术,观察胃癌原发部位、外周浸润及远处转移情况。结果所有患者MSCT图像质量均显示满意,均发现胃部原发病灶并获得胃周浸润、淋巴结转移、远处转移较满意的诊断率。结论MSCT多期扫描及图像后处理可以揭示胃癌原发部位、外周浸润及远处转移情况,对胃癌的诊断、术前评估及治疗方法选择具有重要意义。MSCT可在很大程度上提高微小病变的检出率,可对癌肿侵犯胃壁的深度、区域淋巴结转移、周围脏器浸润以及远处转移情况做出较为准确的判断。MSCT多期扫描及图像后处理可一次性获取多方面信息,可取代胃癌术前评估的X线上消化道造影检查。

Objective To study the diagnostic value of multislice spiral computed tomography （MSCT） including multi-stage scan and post-processing techniques in gastric carcinoma .Methods 25 cases of gastric carcinoma ,which were path-ologically proved ,underwent plain scanning ,triphase enhancement scanning and three-dimensional reconstruction scanning ,then ,many kinds of post-processing technology including multi-planar reconstuction ,volume rendering and CT virtual endoscopy were performed to observe primary lesions in stomach ,infiltration and distant metastasis .Results All parameters were obtained and the image was satisfactory .It was clearly shown that the primary lesions were in stomach and the infiltration was around them ,same to the lymph node metastasis .Conclusion It could be revealed primary lesions in stomach and infiltration and distant metastasis by MSCT multistage scan and post-processing techniques .It is significant for preoperative evaluation and the choice of therapeutics way of gastric carcinoma .MSCT can increase the detection rate of small focus of infection ,with high accuracy in judgement of invasive depth and regional lymph node metastasis of gastric carcinoma ,and the superiority in evaluating the distant metastases and the involvement of surrounding organs .MSCT multistage scan and post-processing techniques can achieve many-sided information ,which can replace preoperative evaluation of gastric carcinoma by X-ray radiography of upper digestive tract .