胃癌的CT与内镜对照研究(附89例分析)

Gastric Carcinoma: A Correlative Study of CT and Endoscopy

目的 探讨螺旋CT(SCT)及内镜在胃癌诊断及术前分期中的价值 ,并就二者的相关性进行对照研究。方法 89例胃癌患者在术前行SCT及内镜检查。CT扫描采取患者口服水及低张处理 ,增强扫描时相分别设置为动脉期、门静脉期及延迟期。结果 ① 9例早期胃癌 (EGC)均为内镜所诊断 ,而仅 2例为CT检出。② 80例进展期胃癌 (AGC)内镜的检出率及诊断准确率分别为 95 %、90 % ;而CT的检出率及诊断率为 90 %、87.5 %。③SCT对于AGC的分期 :单相 (平扫 )扫描准确率为 70 % ,多相 (平扫 +三期增强 )扫描为 91.8%。结论 内镜在EGC的诊断方面优于SCT ,而在AGC的定位及定性诊断方面与SCT相当 ,判断术前分期是CT的独到优势 。

Purpose To study the clinical value of CT and endoscopy in the diagnosis and staging of gastric carcinoma, and to evaluate the correlation between them. Methods Eighty nine patients with histologically proven gastric carcinoma underwent SCT and endoscopy.They were scanned with drug induced hypotonia and water filling in non contrast and /or contrast examination of artery,portal venous and delay phase,which were performed after 75ml non ionic contrast media injected. Results ① All the nine EGC cases were detected and diagnosed by endoscopy,but only two cases were detected by SCT and one was diagnosed.② In 80 AGC cases,the accuracy of endoscopy in detection and diagnosis were 95% and 90% respectively,while 90% and 87.5% in SCT.③The accuracy of staging of the tumers of the non contrast scan was 70%,and multiphase scan was 91.8%. Conclusion Endoscopy is better than SCT on the diagnosis of EGC,but they both have advantage on diagnosis and location of AGC. Preoperative Staging of AGC is evaluated only by SCT,so CT and endoscopty should be both used in gastric carcinoma.