CT多向调整MPR重建技术在胃癌Borrmann Ⅱ型和Ⅲ型鉴别诊断中的价值

Value of computed tomography with multidirection adjusting multiplanar reformation in differential diagnosis between Borrmann types Ⅱ and Ⅲ gastric cancer

目的:探讨计算机断层扫描(c o m p u t e d tomography,CT)多向调整多曲面重建技术(multi-planar reformation,MPR)较常规重建技术在胃癌BorrmannⅡ型和Ⅲ型鉴别诊断中的价值,提高CT对胃癌术前评估的效能.方法:搜集经手术病理证实为溃疡型胃癌且术前均行腹部平扫加增强的患者80例,分别进行常规冠状位、矢状位重建和多向调整M P R重建,分别以病理诊断作为金标准,绘制四格表后经χ2检验计算出两种重建方法与病理诊断的一致性、准确性.结果:33例为BorrmannⅡ型,47例为Ⅲ型,多向调整MPR重建对两种类型胃癌的诊断的Kappa值为0.77,准确性为88.8%,均高于常规重建技术诊断的Kappa值和准确性;对Ⅱ型的诊断效能高于Ⅲ型.结论:CT多向调整MPR重建技术较常规的重建技术对BorrmannⅡ型和Ⅲ型鉴别诊断的准确性更高,更接近病理诊断.

AIM： To evaluate the value of computed tomography（CT） with multi-direction adjusting multi-planar reformation（MPR） inthe differential diagnosis between Borrmann types Ⅱ and Ⅲ gastric cancer.METHODS： Eighty patients with pathologically proven gastric cancer underwent contrast enhanced CT examinations, and all the images were reconstructed by multi-direction adjusting MPR and normal reformation. The diagnostic results by the two construction methods were compared with the pathology as the gold standard, and the consistency and accuracy were analyzed by the Chi-square test.RESULTS： Of the 80 patients, 33 had Borrmann type Ⅱ disease and 47 had Borrmann type Ⅲ.The value of Kappa and accuracy of multidirection adjusting MPR in the differential diagnos i s be twe en Bor rmann type s Ⅱand Ⅲ gastric cancer were 0.77 and 88.8%,respectively, which were higher than those of the normal reformation. Borrmann type Ⅱgastric cancer was diagnosed more easily than type Ⅲ.CONCLUSION： The accuracy of multi-direction adjusting MPR in the differential diagnosis between Borrmann types Ⅱ and Ⅲ gastric cancer is higher than the normal reformation and is close to pathology.