CTA技术判断胃癌周围血管受累情况对胃癌根治术的临床应用价值

Clinical value of CTA technique in determining peripheral vascular involvement of gastric cancer in radical operation of gastric cancer

目的观察64层螺旋CT血管成像技术(CTA)对术前胃癌血管受累情况的诊断敏感性及特异性。方法选取2013-01—2015-12间术前行CT检查筛查出胃癌手术适应证的26例患者。将每例患者的19支血管(包括10条静脉和9条动脉)作为研究对象(共494支)。通过CTA对上述血管进行探查,判断胃周血管的受累情况和受侵表现。同时与术中探查结果进行对比。结果 CTA判断胃静脉侵犯情况的灵敏度为92.00%,特异度为99.53%。CTA判断胃动脉侵犯情况的灵敏度为96.15%,特异度为98.74%。CTA检测与手术探查在判断血管管腔狭窄或扩大表现时差异有统计学意义(χ~2=4.44,P=0.035)。结论 64层螺旋CT血管成像技术是术前判断胃癌血管受累情况的有效方法。

Objective To investigate the diagnostic sensitivity and specificity of 64 slice spiral CT angiography for the vascular invasion in preoperative gastric cancer. Methods Totally 26 of patients with gastric cancer confirmed by CT scanning in our hospital from January 2013 to December 2015 were selected as study subjects. 494 vessels of the patients were explored by CTA. The involvement of gastric vessels and the expression of invasion were judged, and the results were compared with the results of the operation. Results The sensitivity and specificity of CTA for assessing gastric vein vascular in vasion were 92% and 99. 53% , respectively. The sensitivity and specificity of CTA for assessing gastric vein vascular in vasion were 92. 00% and 99. 53%, respectively while for assessing gastric arter yvascular in vasion were 96. 15% and 98.74% , the difference was statistically significant in the judgment of vascular lumen stenosis or the expansion of performance between the CTA detection and the surgical exploration（ X2 = 4. 44, P = 0. 035 ）. Conclusion 64 slice spiral CT is an effective method to determine the vascular involvement of gastric cancer before operation.