CAJ | 학술논문

目的:研究多层螺旋 CT(Multi-detector row computed tomography,MDCT)增强扫描加多平面重建(Multiplanar recon?struction,MPR)技术对腹膜转移癌(Peritoneal carcinomatosis,PC)的诊断效能,分析PC的典型CT征象.方法:对54例PC患者术前进行MDCT多期增强扫描,分析MDCT横断位图像及MPR图像,与术中探查结果进行比较.结果:54例PC患者MDCT增强扫描检测出356个病灶,在1~13分区中每例患者检测出病灶平均数为(6.5±3.4)个.常见转移部位是大网膜、左半膈、脾包膜、盆腔、右半膈、胃周韧带等.转移病灶密度以实性为主,病灶直径为0.5~13 cm.总体敏感度为78.1%(356/456),特异度为92.3%(277/300);病灶≥0.5 cm 时,敏感度为90.0%(307/341),病灶<0.5 cm 时,敏感度为42.6%(49/115).CT-腹膜癌指数(Peritoneal carcinomatosis in?dex,PCI)与术中PCI的吻合度为0.384~0.640(P<0.05).结论:MDCT增强扫描加MPR技术可较准确评估CT-PCI,与术中PCI有较高的吻合度,可为临床制定治疗计划提供依据.
목적:연구다층라선 CT(Multi-detector row computed tomography,MDCT)증강소묘가다평면중건(Multiplanar recon?struction,MPR)기술대복막전이암(Peritoneal carcinomatosis,PC)적진단효능,분석PC적전형CT정상.방법:대54례PC환자술전진행MDCT다기증강소묘,분석MDCT횡단위도상급MPR도상,여술중탐사결과진행비교.결과:54례PC환자MDCT증강소묘검측출356개병조,재1~13분구중매례환자검측출병조평균수위(6.5±3.4)개.상견전이부위시대망막、좌반격、비포막、분강、우반격、위주인대등.전이병조밀도이실성위주,병조직경위0.5~13 cm.총체민감도위78.1%(356/456),특이도위92.3%(277/300);병조≥0.5 cm 시,민감도위90.0%(307/341),병조<0.5 cm 시,민감도위42.6%(49/115).CT-복막암지수(Peritoneal carcinomatosis in?dex,PCI)여술중PCI적문합도위0.384~0.640(P<0.05).결론:MDCT증강소묘가MPR기술가교준학평고CT-PCI,여술중PCI유교고적문합도,가위림상제정치료계화제공의거.
Objective: This study aims to determine the clinical value of a multi-detector row computed tomography (MDCT) combined with multiplanar reconstruction (MPR) for the diagnosis of peritoneal carcinomatosis (PC), as well as to analyze the typical computed tomography (CT) features of PC. Methods: Fifty-four PC patients underwent MDCT and MPR before surgery. The results of the CT scan were analyzed by radiologists and oncologists by comparing the sensitivity and specificity with the intraoperative findings. Results: A total of 356 PC lesions were found in all 54 patients after enhanced CT scanning, ranging from 1 to 13 (average 6.5±3.4) for each patient. The most frequently observed PC sites were the greater omentum, left hemidiaphragm, splenic capsule, pelvis, right hemidiaphragm, and gastric ligaments. The PC lesions were mainly solid, with a diameter range of 0.5 cm to 13 cm. The overall sensitivity was 78.1% (356/456), and the overall specificity was 92.3% (277/300). The sensitivity was 90% (307/341) for the lesions ≥ 0.5 cm, was reduced to 42.6% (49/115) for the lesions <0.5 cm. The degree of fitness between the CT-peritoneal carcinomatosis index (CT-PCI) and the intraoperative PCI was 0.384 to 0.640 (P<0.05). Conclusion: MDCT and MPR can help determine a good degree of fitness of the CT-PCI value with the intraoperative findings and can significantly inform decision-making on treatment options for peritoneal carcinomatosis.