多层螺旋CT增强扫描应用于胃癌淋巴结转移诊断的可行性研究

Feasibility study on application of enhanced multi-slice spiral CT scanning in diagnosis of lymph node metastasis in gastric cancer

目的探讨应用多层螺旋CT增强扫描诊断胃癌淋巴结转移的可行性。方法选择2019年1月-2020年6月本院收治的胃癌患者40例作为研究对象,术前行CT增强扫描,观察转移淋巴结的CT表现,并与术后病理检查结果比较,评估多层螺旋CT增强扫描在胃癌淋巴结转移中的诊断价值。结果40例胃癌患者经多层螺旋CT增强扫描发现,淋巴结转移多位于肿瘤细胞引流区域内,密度均匀,可呈中心相对囊状或环形状中心相对低密度周边高密度表现,主要包括囊状、环状及实体性淋巴结3种类型,其中囊状及环状多见于较大淋巴结。40例胃癌患者术后病理检查证实发现淋巴结转移13例,未转移27例;经CT增强扫描显示淋巴结转移12例,未转移28例;而经CT平扫显示淋巴结转移16例,未转移24例。CT增强扫描敏感度(92.31%)、特异度(100.0%),与CT平扫的敏感度(92.31%)、特异度(86.19%)比较,差异无统计学意义(P>0.05);而CT增强扫描诊断符合率(97.50%)明显高于CT平扫(87.50%),差异有统计学意义(P<0.05)。结论针对胃癌患者行多层螺旋CT增强扫描可提高淋巴结转移的检出率,直观显示淋巴结的病理特性,临床推广应用价值较高。

Objective To explore the feasibility of using enhanced multi-slice spiral CT scanning in the diagnosis of lymph node metastasis in gastric cancer.Methods A total of 40 gastric cancer patients those were admitted to our hospital from January 2019 to June 2020 were selected as study objects.The enhanced CT scan was performed before the operation to observe the CT manifestations of metastatic lymph nodes,and compared with the postoperative pathological examination results to evaluate the diagnostic value of enhanced multi-slice spiral CT scan in lymph node metastasis of gastric cancer.Results In 40 patients with gastric cancer,the enhanced scanning of multi-slice spiral CT showed that lymph node metastases were mostly located in the drainage area of tumor cells,with uniform density,which could be relatively cystic or ring-shaped in the center,with low-density in the central and high-density around the periphery,mainly including three types of lymph nodes of sac-like and ring-shaped,and solid lymph nodes,of which cystic and circular are more common in larger lymph nodes.Postoperative pathological examination of the 40 patients with gastric cancer confirmed that 13 had lymph node metastasis and 27 without metastasis,enhanced CT scan showed 12 had lymph node metastasis,and 28 had no metastasis,while CT plain scan showed 16 had lymph node metastasis and 24 had no metastasis.The sensitivity(92.31%)and specificity(100.0%)of enhanced CT scan and the sensitivity(92.31%)and specificity(86.19%)of plain CT scan were not statistically different(P>0.05),while the diagnostic coincidence rate of CT enhancement scanning(97.50%)was significantly higher than that of plain CT scanning(87.50%)(P<0.05).Conclusions Multi-slice spiral CT enhanced scanning for patients with gastric cancer could increase the detection rate of lymph node metastasis,visually display the pathological characteristics of lymph nodes,and has a high clinical application value.