多层螺旋CT对胃癌T分期的术前诊断价值

摘要

目的 研究胃癌多层螺旋CT (muhidetector computed tomography,MDCT)的影像特点,探讨其对胃癌T分期的术前诊断价值.方法分别对经手术病理证实的60例胃癌患者进行MDCT平扫及增强三期扫描,分析其CT影像特点并对其进行术前T分期,按WHO对胃癌的T分期标准对其进行临床分期并对CT与临床分期对比分析.结果60例胃癌发生于胃窦部38例(63.3％),胃体部8例(13.3％),贲门部14例(23.3％).多排螺旋CT对胃癌术前T分期诊断的准确性为80.00％；对T1期、T2期、T3期、T4期诊断的准确性分别为40.00％、66.67％、83.33％和88.00％；敏感性分别为40.00％、66.67％、83.33％和88.00％；特异性分别为100％、98.15％ 、100％和100％.结论MDCT对胃癌术前T分期与手术病理分期具有良好的对应性,对术前术式方案的制定具有重要的临床意义.%Objective To study multidetector computed tomography ( MDCT) image of gastric carcinoma and explore its preoperative values of diagnosing. Methods MDCT was performed in 60 patients with gastric carcinoma diagnosed by surgical pathological findings. Preoperative T staging was analyzed according to the inmage of MDCT. The clinic stage is assessed by T staging of gastric carcinoma of WHO, which compared with T staging by MDCT. Results 38 case (63.3% ) ,8 case (13.3% ) and 14case(23.3% )0f gastric carcinoma are located in the gastric antrum, gastric body and cardia. The MDCT had 80.00% of accuracy for diagnosingT stage,and 40.00%、66.67% ,83. 33% and 88.00% accuracy for T1 ,T2,T3,and T4,respectively. The sensitivity of the diagnosis were 40.00% ,66.67% ,83.33% and 88. 00% for Tl ,T2,T3,and T4,respectively. The specificity of the diagnosis were 100% ,98. 15% ,100% and 100% for Tl ,T2,T3 ,and T4,respectively. Conclusion Staging by MDCT is coincident with surgical pathological Staging. MDCT have clinical significance for selecting opretion way.