多排螺旋CT多平面重建技术对胃腺癌T、N分期及转移淋巴结的诊断价值

Diagnostic value of multi-slice spiral CT multiplanar reconstruction for T,N staging of gastric adenocarcinoma and lymph node metastasis

目的探讨多排螺旋CT(MDCT)多平面重建技术对胃腺癌T、N分期及转移淋巴结的诊断价值。方法分析58例胃腺癌患者临床资料,所有患者均接受MDCT扫描,以术后病理结果为金标准,分析MDCT多平面重建技术对胃腺癌T、N分期及转移淋巴结的诊断价值。结果 MDCT多平面重建技术对胃腺癌T分期诊断的总准确率为82.76%(48/58),MDCT多平面重建技术对T1、T2、T3、T4分期诊断的准确率分别为100%(7/7)、66.67%(4/6)、75.00%(6/8)、83.78%(31/37);MDCT多平面重建技术对胃腺癌N分期诊断的总准确率为75.86%(44/58),MDCT多平面重建技术对N0、N1、N2、N3分期诊断的准确率分别为86.67%(13/15)、66.67%(4/6)、64.29%(9/14)、78.26%(18/23);胃腺癌转移淋巴结组的淋巴结短径、短长径之比均高于非转移淋巴结组,差异均有统计学意义(t分别=11.14、12.26,P均<0.05);MDCT多平面重建技术诊断胃腺癌转移淋巴结的准确度、特异度、灵敏度分别为75.86%(44/58)、66.67%(10/15)、79.07%(34/43)。结论 MDCT多平面重建技术能提高胃腺癌临床T、N分期及转移淋巴结诊断的准确性,与病理结果具有较好的一致性。MDCT多平面重建技术能较清楚显示肿瘤胃壁浸润及转移淋巴结情况。

Objective To explore the diagnostic value of multi-slice spiral CT(MDCT)multiplanar reconstruction for T,N staging of gastric adenocarcinoma and lymph node metastasis.Methods The clinical data of 58 patients with gastric adenocarcinoma were analyzed.All patients underwent MDCT scan.Taking postoperative pathological results as the golden standard,the diagnostic value of MDCT multiplanar reconstruction for T,N staging of gastric adenocarcinoma and lymph node metastasis was analyzed.Results The total accuracy rate of MDCT multiplanar reconstruction in the diagnosis of T staging of gastric adenocarcinoma was 82.76%(48/58).The accuracy rates of MDCT multiplanar reconstruction in the diagnosis of stages T1,T2,T3,and T4 were 100%(7/7),66.67%(4/6),75.00%(6/8),and 83.78%(31/37),respectively.The total accuracy rate of MDCT multiplanar reconstruction in the diagnosis of N staging of gastric adenocarcinoma was 75.86%(44/58).The accuracy rates of MDCT multiplanar reconstruction in the diagnosis of stages N0,N1,N2,and N3 were 86.67%(13/15),66.67%(4/6),64.29%(9/14),and 78.26%(18/23),respectively.The short diameter and ratio of short diameter to long diameter in lymph node metastasis group were higher than those in non-metastasis group(t=11.14,12.26,P<0.05).The accuracy,specificity,and sensitivity of MDCT multiplanar reconstruction in the diagnosis of lymph node metastasis were 75.86%(44/58),66.67%(10/15),and 79.07%(34/43),respectively.Conclusion MDCT multiplanar reconstruction can improve the diagnostic accuracy in T,N staging of gastric adenocarcinoma and lymph node metastasis,with good consistency with pathological results.MDCT multiplanar reconstruction can display gastric wall inva-sion of tumors and metastatic lymph nodes more clearly.