实用放射学杂志
實用放射學雜誌
실용방사학잡지
JOURNAL OF PRACTICAL RADIOLOGY
2015年
8期
1283-1286
,共4页
左阳%刘丽东%苏丹柯%金观桥%朱旭娜%赵欣%刘宇%刘思远
左暘%劉麗東%囌丹柯%金觀橋%硃旭娜%趙訢%劉宇%劉思遠
좌양%류려동%소단가%금관교%주욱나%조흔%류우%류사원
胃癌%计算机体层成像%T分期
胃癌%計算機體層成像%T分期
위암%계산궤체층성상%T분기
gastric cancer%computed tomography%T staging
目的:探讨 CT 强化值及形态学表现在不典型 T4a 期胃癌分期诊断中的参考价值。方法回顾性分析 CT 表现为浆膜面光滑的胃癌 T3、T4a 期术后病例共51例。采用盲法在胃壁浆膜下紧临浆膜处病灶区选取感兴趣区并测量平扫、动脉期、静脉期的 CT 值,使用 SPSS22.0计算各期 CT 值及动、静脉期强化值的均数,使用 Medcalc12.7绘制受试者工作特征曲线(ROC)并采用 Z检验分析各期 CT 值及动、静脉期 CT 强化值对胃癌 T4a 期分期诊断效能间的差异性(P <0.05);使用 Medcalc12.7采用 Z 检验法分析前述 CT 值法诊断效能最佳者与常规 CT 形态学诊断标准(即病灶浆膜面有无结节状突起等)及二者相结合法诊断胃癌 T4a 期诊断效能间的差异性(P<0.05),并计算3种方法诊断敏感度及特异度。结果 CT静脉期-平扫强化值诊断效能最佳,以 CT 强化值43.6 HU 为胃癌 T4a 期诊断阈值时,敏感度为74.07%,特异度为70.83%,曲线下面积(AUC)0.82;常规 CT 形态学诊断标准的敏感度为66.67%,特异度为33.33%;将常规 CT 形态学诊断标准与 CT静脉期-平扫强化值并联结合后诊断敏感度为100.00%,特异度为26.31%。结论CT静脉期-平扫强化值对胃癌 T4a 期的诊断效能高于常规 CT 形态学诊断标准。
目的:探討 CT 彊化值及形態學錶現在不典型 T4a 期胃癌分期診斷中的參攷價值。方法迴顧性分析 CT 錶現為漿膜麵光滑的胃癌 T3、T4a 期術後病例共51例。採用盲法在胃壁漿膜下緊臨漿膜處病竈區選取感興趣區併測量平掃、動脈期、靜脈期的 CT 值,使用 SPSS22.0計算各期 CT 值及動、靜脈期彊化值的均數,使用 Medcalc12.7繪製受試者工作特徵麯線(ROC)併採用 Z檢驗分析各期 CT 值及動、靜脈期 CT 彊化值對胃癌 T4a 期分期診斷效能間的差異性(P <0.05);使用 Medcalc12.7採用 Z 檢驗法分析前述 CT 值法診斷效能最佳者與常規 CT 形態學診斷標準(即病竈漿膜麵有無結節狀突起等)及二者相結閤法診斷胃癌 T4a 期診斷效能間的差異性(P<0.05),併計算3種方法診斷敏感度及特異度。結果 CT靜脈期-平掃彊化值診斷效能最佳,以 CT 彊化值43.6 HU 為胃癌 T4a 期診斷閾值時,敏感度為74.07%,特異度為70.83%,麯線下麵積(AUC)0.82;常規 CT 形態學診斷標準的敏感度為66.67%,特異度為33.33%;將常規 CT 形態學診斷標準與 CT靜脈期-平掃彊化值併聯結閤後診斷敏感度為100.00%,特異度為26.31%。結論CT靜脈期-平掃彊化值對胃癌 T4a 期的診斷效能高于常規 CT 形態學診斷標準。
목적:탐토 CT 강화치급형태학표현재불전형 T4a 기위암분기진단중적삼고개치。방법회고성분석 CT 표현위장막면광활적위암 T3、T4a 기술후병례공51례。채용맹법재위벽장막하긴림장막처병조구선취감흥취구병측량평소、동맥기、정맥기적 CT 치,사용 SPSS22.0계산각기 CT 치급동、정맥기강화치적균수,사용 Medcalc12.7회제수시자공작특정곡선(ROC)병채용 Z검험분석각기 CT 치급동、정맥기 CT 강화치대위암 T4a 기분기진단효능간적차이성(P <0.05);사용 Medcalc12.7채용 Z 검험법분석전술 CT 치법진단효능최가자여상규 CT 형태학진단표준(즉병조장막면유무결절상돌기등)급이자상결합법진단위암 T4a 기진단효능간적차이성(P<0.05),병계산3충방법진단민감도급특이도。결과 CT정맥기-평소강화치진단효능최가,이 CT 강화치43.6 HU 위위암 T4a 기진단역치시,민감도위74.07%,특이도위70.83%,곡선하면적(AUC)0.82;상규 CT 형태학진단표준적민감도위66.67%,특이도위33.33%;장상규 CT 형태학진단표준여 CT정맥기-평소강화치병련결합후진단민감도위100.00%,특이도위26.31%。결론CT정맥기-평소강화치대위암 T4a 기적진단효능고우상규 CT 형태학진단표준。
Objective To evaluate the diagnostic performance of enhancement value and morphological features by using mul-tiphasic MDCT on differentiating untypical T4a from T3 gastric cancer.Methods Fifty-one histopathologically proven T3 and T4a gastric cancer patients with smooth serosa were collected retrospectively.Three radiologists read all images regarding morphological features,while the CT value and enhancement value of regions of interest (ROIs)located in the outer of lesion were calculated.Cut-off analysis was performed to determine optimal threshold levels of enhancement value to discriminate T4a and T3 gastric cancer.Di-agnostic performance of enhancement value and combination of enhancement value and morphologic assessment were compared with morphologic assessment by means of receiver operating characteristic (ROC)curve analysis.Results The sensitivity and specificity of morphological features was 66.67% and 33.33% respectively;the area under the ROC of enhancement value (between venous phase and plain scan)for differentiating T4a from T3 gastric cancer was 0.82,with a cut-off at 43.6 HU,sensitivity of 74.07% and specificity of 70.83%.Combined conventional standard and enhancement value,sensitivity of 100.00% and specificity 26.31%. Conclusion For differentiation of T4a and T3 gastric cancer by means of MDCT,enhancement value is found to be superior to con-ventional standard.