CAJ | 학술논문

目的探讨64层螺旋CT三期动态增强扫描对胃癌进行术前TNM分期的临床价值.方法回顾性分析2009年5月至2011年5月赣南医学院第一附属医院收治的120例胃癌患者的术前64层螺旋CT三期动态增强扫描资料和术后病理资料,由两名高年资影像科医生采用双盲法进行术前影像学分期.结果术前64层螺旋CT增强扫描对胃癌T分期判断的总体准确率为79.2％(95/120),其中对T1、T2、T3和T4期判断的准确率分别为66.7％(10/15)、66.7％(14/21)、84.0％(42/50)和85.3％(29/34).对于单层胃壁结构和多层胃壁结构,CT增强扫描对T分期的准确率分别为59.4％(19/32)和81.8％(72/88),差异有统计学意义(P＜0.05).CT增强扫描对N分期判断的总体准确率为73.9％(85/115),其中对N0、N1和N2期判断的准确率分别为75.5％(37/49)、70.3％(26/37)和75.9％(22/29);对M分期判断的准确率为89.2％(107/120).结论 64层螺旋CT三期动态增强扫描可早期动态观察肿瘤累及侵犯情况、淋巴转移及远处转移的情况,有望成为胃癌术前分期有重要意义的检查项目之一.
목적 탐토64층라선CT삼기동태증강소묘대위암진행술전TNM분기적림상개치.방법 회고성분석2009년5월지2011년5월공남의학원제일부속의원수치적120례위암환자적술전64층라선CT삼기동태증강소묘자료화술후병리자료,유량명고년자영상과의생채용쌍맹법진행술전영상학분기.결과 술전64층라선CT증강소묘대위암T분기판단적총체준학솔위79.2％(95/120),기중대T1、T2、T3화T4기판단적준학솔분별위66.7％(10/15)、66.7％(14/21)、84.0％(42/50)화85.3％(29/34).대우단층위벽결구화다층위벽결구,CT증강소묘대T분기적준학솔분별위59.4％(19/32)화81.8％(72/88),차이유통계학의의(P＜0.05).CT증강소묘대N분기판단적총체준학솔위73.9％(85/115),기중대N0、N1화N2기판단적준학솔분별위75.5％(37/49)、70.3％(26/37)화75.9％(22/29);대M분기판단적준학솔위89.2％(107/120).결론 64층라선CT삼기동태증강소묘가조기동태관찰종류루급침범정황、림파전이급원처전이적정황,유망성위위암술전분기유중요의의적검사항목지일.
Objective To explore the clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM staging assessment of gastric carcinoma.Methods A retrospective study was performed to review the 64-slice spiral 3-phase CT enhanced scanning of 120 patients with gastric cancer diagnosed by biopsy prior to operation and postoperative pathological reports.All the findings were reviewed by two senior radiologic diagnosticians separately and compared with pathological findings.Results The accuracy of 64-slice spiral CT enhanced scan was 79.2％(95/120) for T staging,66.7％(10/15 for T1,66.7％(14/21) for T2,84.0％(42/50) for T3,and 85.3％(29/34) for T4.For gastric wall with single layer and multiple layers,the accuracy of CT enhanced scanning was 59.4％(19/32) and 81.8％(72/88) for T staging,and the difference was statistically significant(P＜0.05).The accuracy of 64-slice spiral CT enhanced scan was 73.9％ (85/115) for N staging,75.5％ (37/49) for N0,70.3％ (26/37) for N1,75.9％ (22/29) for N2.The accuracy of 64-slice spiral CT enhanced scanning was 89.2％ for M staging.Conclusion 64-slice spiral CT 3-phase enhanced scanning can monitor the invasion,lymphatic metastatsis,and distant metastasis of gastric cancer dynamically,which may become an important examination item for the preoperative evaluation of gastric cancer.