超声双重造影在进展期胃癌诊断及疗效评估中的研究

Utility of double contrast-enhanced ultrasonography in diagnosis and treatment evaluation of advanced gastric carcinoma

目的双重造影为一种临床检测手段,本研究旨在探讨超声双重造影在进展期胃癌诊断及疗效评估中的作用。方法评估2005—2012年间超声双重造影与二维超声对进展期胃癌诊断的准确度,同时分析进展期胃癌患者经手术及放化疗治疗后,超声显示胃壁的基础强度(BI)及峰值强度(PI)的变化。所有诊断均病理确诊,其中,150例患者采用了超声双重造影进行诊断,120例患者采用了二维超声诊断。结果超声双重造影对进展期胃癌的检出率为84%(126/150),二维超声对进展期胃癌的检出率为68.3%(82/120),二者差异明显,具有统计学意义(P=0.003)。进展期胃癌经手术切除后并予以放化疗,再经超声双重造影复查,结果示术前患者肿瘤区域胃壁的超声基础强度(BI)为(25.04±2.14)d B,术后经放疗或化疗治疗后胃壁的基础强度(BI)为(22.11±2.35)d B,差异具有统计学意义(P<0.05)。同时,示术前患者肿瘤区域胃壁的超声峰值强度(PI)为(17.36±2.74)d B,术后经放疗或化疗治疗后胃壁的超声峰值强度为(14.23±2.12)d B,差异具有统计学意义(P<0.05)。结论超声双重造影有助于进展期胃癌的术前诊断及治疗后的疗效评估。

Objective To investigate the utility of double contrast-enhanced ultrasonography（DCEUS） in the diagnosis and treatment evaluation of advanced gastric carcinoma （AGC）. Methods The accuracy between double contrast-en- hanced uhrasonography and general two-dimensional used in the diagnosis of advanced gastric carcinoma was evaluated, and the changes of basic intensity（BI） and peak intensity（PI） of ultrasound patients in patients who underwent surgery, radiotherapy and chemotherapy treatment during the year of 2005 and 2012 were assessed. All diagnosis was pathologically confirmed,which contained 150 patients with double contrast-enhanced ultrasonography and 120 patients with a two-di- mensional ultrasound diagnosis. Results The results showed that the positive rate of ultrasonic of double contrast-en- hanced ultrasonography for advanced gastric cancer was 84% （ 126/150）, the the positive rate of two-dimensional ultra- sound for advanced gastric cancer was 68.3 % （82/120）, and the difference was significant （P = 0.003 ）. After the surgi- cal resection, advanced gastric cancer patients received radiotherapy and chemotherapy, and then double ultrasound angi- ography was used to detect the basic intensity（BI） and peak intensity（PI）. The results showed the basic intensity（BI） value in patients before surgery was （25.04 ± 2.14 ） dB, but in patients after surgery was （22.11 ±2.35 ） dB, with a signif- icant difference （ P 〈 0.05 ）. Meanwhile, the peak intensity （PI） in patients before surgery was （ 17.36 ± 2.74 ） dB, which was significantly higher than that in postsurgical patients（ 14.23 ± 2.12 ）dB, and the differences were statistically signifi- cant（ P 〈 0.05 ）. Conehmion Double contrast-enhanced ultrasonography can be helpful to assess the preoperative diag- nosis and postoperative treatment evaluation in advanced gastric cancer.