超声内镜、MSCT扫描在胃癌术前诊断和分期中的应用分析

Application Value of Endoscopic Ultrasonography and MSCT Scanning in Preoperative Staging Diagnosis of Gastric Cancer

目的旨在探讨超声内镜、多层螺旋CT(MSCT)扫描检查在胃癌术前诊断和分期中的应用价值。方法对2016年1月~2018年8月延安大学附属医院收治的64例胃癌患者临床、影像资料,以病理学检查结果为标准,总结不同检查方法对胃癌的诊断符合率及影像表现。结果超声内镜联合MSCT检查对胃癌患者术前T、N、M分期诊断符合率均显著高于超声内镜和MSCT单独检查者(P<0.05)。超声内镜示早期胃癌表现为病灶呈现不规则隆起,以低回声显示,且病灶主要浸润1、2层;晚期胃癌可明表现为低回声病灶侵犯至浆膜层。MSCT示46例患者胃壁上表现为局限性结节状及菜花状阴影,且部分呈多发大小不等卵圆形和轻度分叶状肿块向胃腔内凸起。在平扫过程中,胃部肿块显示密度类似于肌肉,其中呈现均匀密度42例,增强扫描肿块表现为不均匀强化54例,其中有16例肿块病灶内坏死部分以不强化显示。结论超声内镜和MSCT对胃癌患者术前分期诊断均具有一定的临床价值,但超声内镜联合MSCT检查对其分期诊断的符合率更高,应用价值更为显著。

Objective To investigate the application value of endoscopic ultrasonography and multi-slice spiral CT(MSCT)scanning in preoperative staging and diagnosis of gastric cancer.Methods The clinical and imaging data of 64 patients with gastric cancer admitted to the Affiliated Hospital of Yan'an University from January 2016 to August 2018 were collected.The results of pathological examination were taken as the standard.The diagnostic coincidence rate and imaging performance of different examination methods for gastric cancer were summarized.Results The coincidence rate of endoscopic ultrasonography combined with MSCT examination for preoperative T,N,and M staging in patients with gastric cancer was significantly higher than that of endoscopic ultrasonography and MSCT alone(P<0.05).Endoscopic ultrasonography showed that the early gastric cancer showed irregular bulge of the lesion,which was shown by hypoechoic,and the lesion mainly infiltrated the layers 1 and 2,the advanced gastric cancer could show that hypoechoic lesions infiltrated the serosal layer.MSCT showed that 46 patients had localized nodular and cauliflower-like shadows on the stomach wall,and some of them showed multiple ovoid and mildly lobulated masses protruding into the gastric cavity.In the plain scan,the gastric mass showed density similar to that of the muscle,and the masses of 42 cases showed a uniform density.After further enhanced scan,the masses of 54 cases showed uneven enhancement.Among them,necrotic part of 16 cases in the lesion were not enhanced.Conclusion Endoscopic ultrasonography and MSCT have certain clinical value in preoperative staging diagnosis of gastric cancer.However,the coincidence rate of endoscopic ultrasonography combined with MSCT examination for preoperative staging diagnosis is higher,and the application value is more significant.