特殊兴趣放射学可改善胃癌术前分期的评估。

Special interest radiology improves the perceived preoperative stage of gastric cancer.

作者信息

Barry J D, Edwards P, Lewis W G, Dhariwal D, Thomas G V

机构信息

Department of Surgery, Royal Gwent Hospital, Newport, South Wales NP20 2UB, United Kingdom.

出版信息

Clin Radiol. 2002 Nov;57(11):984-8. doi: 10.1053/crad.2002.1073.

DOI:10.1053/crad.2002.1073

PMID:12409108

Abstract

AIM

The aim of this study was to compare the accuracy of spiral computed tomography (CT) performed by a specialist radiologist within a multi disciplinary team (MDT) framework with that of radiologists working outside of this framework.

MATERIALS AND METHODS

One hundred and ten patients [median age 70 (35-86)yr, 71m] underwent either a preoperative CT performed by the MDT specialist consultant radiologist (n=60) or a CT performed by one of 13 other consultant radiologists (n=50). The strength of the agreement between the CT stage and the histopathological stage was determined by the weighted Kappa statistic (Kw).

RESULTS

Sensitivity for T, N and M stage were 64%, 65% and 25% for MDT specialist CT, compared with 24%, 24% and 5% for control CT. Specificity for T, N and M stage were 68%, 59% and 95% for MDT specialist CT compared with 79%, 94% and 93% for control CT. Kw for T, N and M stage were 0.314, 0.350 and 0.255 for MDT specialist CT compared with 0.088, 0.102 and -0.019 for control CT. Unsuspected metastases were found in 12 patients staged by MDT specialist CT compared with 19 patients staged by control CT (Chi2=4.366, df=1,p =0.037).

CONCLUSION

Improved patient selection for surgery should maximize use of limited resource.

摘要

目的

本研究旨在比较多学科团队（MDT）框架内的专科放射科医生所进行的螺旋计算机断层扫描（CT）与该框架外工作的放射科医生所进行的CT的准确性。

材料与方法

110例患者[中位年龄70（35 - 86）岁，71名男性]接受了由MDT专科顾问放射科医生进行的术前CT检查（n = 60）或由其他13名顾问放射科医生之一进行的CT检查（n = 50）。CT分期与组织病理学分期之间的一致性强度由加权Kappa统计量（Kw）确定。

结果

MDT专科CT对T、N和M分期的敏感性分别为64%、65%和25%，而对照CT分别为24%、24%和5%。MDT专科CT对T、N和M分期的特异性分别为68%、59%和95%，而对照CT分别为79%、94%和93%。MDT专科CT的T、N和M分期的Kw分别为0.314、0.350和0.255，而对照CT分别为0.088、0.102和 - 0.019。MDT专科CT分期的患者中有12例发现了意外转移，而对照CT分期的患者中有19例（卡方 = 4.366，自由度 = 1，p = 0.037）。