Chen Feng, Ni Yi-Cheng, Zheng Kai-Er, Ju Sheng-Hong, Sun Jun, Ou Xi-Long, Xu Man-Hua, Zhang Hao, Marchal Guy
Department of Radiology, Zhongda Hospital, Nanjing, Jiangsu Province, China.
World J Gastroenterol. 2003 Jul;9(7):1404-8. doi: 10.3748/wjg.v9.i7.1404.
To evaluate spiral computed tomography (CT) including virtual gastroscopy for diagnosis of gastric carcinoma in comparison with upper gastrointestinal series (UGI), fiberoptic gastroscopy (FG) and histopathology.
Sixty patients with histologically proven gastric carcinoma (54 advanced and 6 early) were included in this study. The results of spiral CT were compared with those of UGI and FG. Two observers blindly evaluated images of spiral CT and UGI and video recording of FG with consensus in terms of diagnostic confidence with a five-point scale. Sensitivities of lesion detection, Borrmann's classification of spiral CT, UGI and FG, as well as the accuracy of TNM staging of spiral CT were determined by comparing them to surgical and histological findings.
The lesion detection rate was 98 % (59/60), 95 % (57/60) and 98 % (59/60) for spiral CT, UGI and FG, respectively. There were no statistical differences in the detection sensitivity among the three techniques (P>0.05). For the sensitivity in Borrmann's classification, spiral CT was higher than that of UGI (P=0.025) and similar to that of FG (P>0.05). The accuracy of spiral CT in staging the gastric carcinoma was 76.7 %. Six cases of early gastric carcinoma were all detected by spiral CT as well as FG.
Spiral CT is equivalent to UGI and FG in the detection of gastric carcinoma, and superior to UGI but similar to FG in the Borrmann's classification of advanced gastric carcinoma. Spiral CT is more valuable than FG in the staging of gastric carcinoma.
通过与上消化道造影（UGI）、纤维胃镜（FG）及组织病理学检查结果相比较，评估螺旋计算机断层扫描（CT）包括虚拟胃镜对胃癌的诊断价值。
本研究纳入60例经组织学证实为胃癌的患者（54例进展期和6例早期）。将螺旋CT的结果与UGI和FG的结果进行比较。两名观察者对螺旋CT和UGI图像以及FG视频记录进行盲法评估，就诊断可信度采用五点量表达成共识。通过与手术及组织学检查结果对比，确定螺旋CT、UGI和FG对病变的检测敏感度、Borrmann分型以及螺旋CT对TNM分期的准确性。
螺旋CT、UGI和FG对病变的检测率分别为98%（59/60）、95%（57/60）和98%（59/60）。三种技术在检测敏感度方面无统计学差异（P>0.05）。对于Borrmann分型的敏感度，螺旋CT高于UGI（P=0.025），与FG相似（P>0.05）。螺旋CT对胃癌分期的准确率为76.7%。6例早期胃癌均被螺旋CT和FG检测到。
螺旋CT在胃癌检测方面与UGI和FG相当，在进展期胃癌的Borrmann分型中优于UGI但与FG相似。螺旋CT在胃癌分期方面比FG更具价值。
