CAJ | 학술논문

目的：从多中心搜集资料，研究螺旋CT间接淋巴造影及多期增强扫描评估胃癌前哨淋巴结的方法及意义。方法2012年6月到2014年6月珠海市第五人民医院影像科采集数据。从无胃癌T0(50例)、cT1-2病人(35男29女)取得SLN标本。SLN影像检查和活检和随后的腹腔镜胃切除术、剖腹胃全切术及胃部分切除术均在珠海市第五人民医院进行。所有研究对象行螺旋CT间接淋巴造影技术及多期增强扫描。结果 T0、Tis、T1、T2、T3之间，间接淋巴造影、多期增强扫描、间接淋巴造影+多期增强扫描、活检四种方法的检出人数没有差异。T4时，间接淋巴造影检出51例(62.96%)，多期增强扫描检出61例(75.30%)，间接淋巴造影+多期增强扫描检出81例(100.0%)，X2=9.271， P=0.000。N1、N2在间接淋巴造影、多期增强扫描、间接淋巴造影+多期增强扫描、活检四种方法的检出人数均有统计学差异(P＜0.05)。N1四种方法的X2是：6.262，N2四种方法的X2是：3.199。螺旋CT三期增强扫描比间接CT淋巴结造影检出率高，X2=8,.482，P=0.000。结论采用螺旋CT间接淋巴造影技术及多期增强扫描对胃癌前哨淋巴结作出术前判断，可为胃癌前哨淋巴节清扫提供术前及术中依据，为胃癌微创手术临床应用打下基础，准确的胃癌分期诊断及淋巴结累及情况的判断也为手术提供影像学参考，从而达到胃癌合理临床手术治疗。
목적：종다중심수집자료，연구라선CT간접림파조영급다기증강소묘평고위암전초림파결적방법급의의。방법2012년6월도2014년6월주해시제오인민의원영상과채집수거。종무위암T0(50례)、cT1-2병인(35남29녀)취득SLN표본。SLN영상검사화활검화수후적복강경위절제술、부복위전절술급위부분절제술균재주해시제오인민의원진행。소유연구대상행라선CT간접림파조영기술급다기증강소묘。결과 T0、Tis、T1、T2、T3지간，간접림파조영、다기증강소묘、간접림파조영+다기증강소묘、활검사충방법적검출인수몰유차이。T4시，간접림파조영검출51례(62.96%)，다기증강소묘검출61례(75.30%)，간접림파조영+다기증강소묘검출81례(100.0%)，X2=9.271， P=0.000。N1、N2재간접림파조영、다기증강소묘、간접림파조영+다기증강소묘、활검사충방법적검출인수균유통계학차이(P＜0.05)。N1사충방법적X2시：6.262，N2사충방법적X2시：3.199。라선CT삼기증강소묘비간접CT림파결조영검출솔고，X2=8,.482，P=0.000。결론채용라선CT간접림파조영기술급다기증강소묘대위암전초림파결작출술전판단，가위위암전초림파절청소제공술전급술중의거，위위암미창수술림상응용타하기출，준학적위암분기진단급림파결루급정황적판단야위수술제공영상학삼고，종이체도위암합리림상수술치료。
Objective To evaluate the significance of spiral CT, indirect lymphography and multi phase enhanced scan on sentinel lymph node in gastric cancer.Methods The data were collected from the department of image in the Fifth People's Hospital of Zhuhai city during 2012 June to 2014June. SLN samples were obtained from the T0 of gastric cancer (50 cases), cT1-2patients (35 male and 29 female). All checks were performed in the Fifth People's Hospital of Zhuhai city, such as SLN imaging, biopsy and subsequent laparotomy laparoscopic gastrectomy, gastric partial hysterectomy and gastricresection. And all the patients were underwent spiral CT indirect lymphography and multi phase enhancement scanning.Results During the T0, Tis, T1, T2, T3 period, the detected number between indirect lymphography, multi phase enhanced scanning, indirect lymphography + multiphase enhanced scanning and biopsies had no difference. But during the T4 period, indirect lymphography detected 51 cases (62.96%), multi phase scan detected 61 cases (75.30%), indirect lymphography + multi phase scan detected 81 cases (100%), and there was significant difference between the four methods (X2=9.271, P=0.000). The detected number of N1, N2 in the four methods were statistically significant difference (P <0.05) , the X2 value were 6.262, 3.199 respectively. The detection rate of helical CT three phases enhanced images was higher than that used indirect CT lymphography (X2=8.482, P=0.000).Conclusion Spiral CT indirect lymphography and multi phase enhanced scan of sentinel lymph node in gastric cancer can help us make judgment and provide preoperative and intraoperative basis for sentinel gastric cancer sentinel lymph node cleaning,and lay the foundation for the clinical application of minimally invasive operation of gastric cancer. Meanwhile the accurate staging of gastric cancer and lymph node involvement judgment also provides image reference for operation, so as to achieve the reasonable operation of gastric cancer clinical treatment.