双源螺旋CT增强扫描多平面重建在胃癌诊断及分期中的价值

Clinical application and value of dual-source spiral CT enhanced scan and multiplanar reformatting in diagnosis of gastric cancer

目的探讨双源螺旋CT增强扫描、多平面(MPR)在胃癌诊断中的临床应用价值。方法回顾性分析335例病理诊断为胃癌的患者资料,所有患者明确病理诊断前在低张状态下行双源螺旋CT上腹部增强扫描检查,应用多平面重建技术对所得CT增强薄层数据进行多方向的多平面重建。结果 335例病例中,单纯轴位数据检出288例,检出率为86.0%;应用多平面重建数据检出320例,检出率为95.5%,两者检出率有显著差异(P<0.05)。常规轴位与MPR图像的术前T分期总体准确率分别为78.3%与89.1%,差异具有显著性意义;2种方法的术前N分期总体准确率分别为73.6%与82.3%,M分期检出率无明显差异。结论应用双源螺旋CT增强多平面重建能显著提高胃癌的检出率,对胃癌术前TNM分期的平均准确率84.6%。

Objective To discuss the clinical application and value of dual-source spiral CT enhanced scan and multiplanar reformatting（MPR） in the diagnosis of gastric cancer. Methods The 335 patients with gastric cancer who conducted dual-source spiral CT enhanced scan of upper abdomen under the hypotonic state before the definite pathological diagnosis were retrospectively analyzed,and had multi-dimensional multiplanar reconstruction for the enhanced thin-section CT data by the multiplanar reformatting technique. Results Of 335 cases,288 cases were detected by simple axial data,the detection rate was 86. 0%,320 cases were detected by MPR,the detection rate was95. 5%,the differences were statistically significant（ P〈0. 05）. The overall accuracy rate of Preoperative T staging by conventional axial and MPR images were 78. 3% and 89. 1% respectively,the difference was statistically significant. The overall accuracy rate of preoperative N staging by two methods were 73. 6% and 82. 3%,respectively,the difference was not significant. Conclusion Application of dual source spiral CT multiplanar reconstruction can significantly improve the detection rate of gastric cancer,and the average accuracy rate of preoperative TNM staging for gastric cancer is 84. 6%.