CAJ | 학술논문

目的：探讨64层螺旋 CT(64-MSCT)三期增强扫描对胃癌转移性淋巴结的诊断价值。方法对30例胃癌患者行64-MSCT 平扫及三期增强扫描，分析胃周转移性淋巴结相关参数。结果判断胃周淋巴结是否转移的参数为：①淋巴结短径≥6 mm；②淋巴结短长径比≥0.6；③淋巴结门脉期 CT 值≥65 HU；④淋巴结门脉期与平扫期 CT 值差≥35 HU。①、②2项参数联合诊断的灵敏度为90.5%，特异度为29.0%；①、②、③3项参数联合诊断的灵敏度为98.2%，特异度为19.4%；4项参数联合诊断的灵敏度为99.7%，特异度为13.2%。另外，淋巴结的形态符合环形强化或粘连成团之一者，亦考虑为转移性淋巴结。结论64-MSCT 三期增强扫描综合应用淋巴结的各项参数，可对胃癌周围淋巴结是否转移做出比较可靠的诊断，具有快速、无创伤、灵敏度较高的特点。
목적：탐토64층라선 CT(64-MSCT)삼기증강소묘대위암전이성림파결적진단개치。방법대30례위암환자행64-MSCT 평소급삼기증강소묘，분석위주전이성림파결상관삼수。결과판단위주림파결시부전이적삼수위：①림파결단경≥6 mm；②림파결단장경비≥0.6；③림파결문맥기 CT 치≥65 HU；④림파결문맥기여평소기 CT 치차≥35 HU。①、②2항삼수연합진단적령민도위90.5%，특이도위29.0%；①、②、③3항삼수연합진단적령민도위98.2%，특이도위19.4%；4항삼수연합진단적령민도위99.7%，특이도위13.2%。령외，림파결적형태부합배형강화혹점련성단지일자，역고필위전이성림파결。결론64-MSCT 삼기증강소묘종합응용림파결적각항삼수，가대위암주위림파결시부전이주출비교가고적진단，구유쾌속、무창상、령민도교고적특점。
Objective To investigate the clinical value of 64-slice spiral computed tomography(64-MSCT)triple-phase enhanced scan in diagnosis of lymphatic metastasis of gastric cancer.Methods Thirty patients with gastric cancer underwent plain and triple-phase enhanced scan by using 64-MSCT to analyze the relevant parameters of lymphatic metastasis.Results The four parameters de-termined metastatic perigastric lymph node as follows:①the short diameter ≥6 mm,②the ratio of short-to-long diameter ≥0.6,③the CT value in the portal venous phase≥ 65 HU,④the difference of CT values between portal venous phase and plain scan≥35 HU.The sensitivity and specificity of combining two parameters (①+②)in diagnosing metastatic lymph node were 90.5% and 29.0%,respectively.The sensitivity and specificity of combining three parameters (①+②+③)were 98.2% and 1 9.4%,respec-tively.The sensitivity and specificity of combining four parameters (①+②+③+④)were 99.7% and 13.2%,respectively.In ad-dition,metastatic lymph nodes were considered if they were ring-enhancement,or adhesions of several lymph nodes.Conclusion The use of 64-MSCT triple-phase enhanced scan and synthesis of various parameters of lymph nodes could lead to reliable diagnosis of lymphatic metastasis in gastric cancer with rapid,non-invasive,high sensitive and specific features.