Yang Dal Mo, Kim Hyun Cheol, Jin Wook, Ryu Chang Woo, Kang Jee Hee, Park Chul Hi, Kim Hyung Sik, Jung Dong Hae
Department of Radiology, East-West Neo Medical Center, Kyung Hee University, Seoul, South Korea.
J Comput Assist Tomogr. 2007 Jan-Feb;31(1):98-103. doi: 10.1097/01.rct.0000234072.16209.ab.
To assess the accuracy of 64 multidetector-row computed tomography (MDCT) in the diagnosis and staging of gastric cancer.
This study was approved by the institutional review board, and the patients involved gave informed consent. Forty-four patients (34 men and 10 women; mean age, 57 years) with gastric carcinoma underwent preoperative 64 MDCT (SOMATOM Sensation 64; Siemens Medical System, Forchheim, Germany; slice collimation, 0.6 mm; slice width, 5 mm; feed/rotation, 23 mm; pitch factor, 1.2; kernel, B30f; and gantry speed, 0.5 second per rotation). Gastric distension was achieved by ingestion of 8 g of effervescent granules. Scanning was performed during arterial and portal phases, as determined with bolus tracking and automated triggering technique after intravenous administration of 100 mL of contrast materials (4 mL/s). All computed tomography scans were retrospectively reviewed by 2 radiologists. Each tumor was staged according to the TNM classification system. All patients underwent surgery. Computed tomography results were compared with histological staging of tumor invasion depth and regional lymph node metastasis.
The accuracy of 64 MDCT for detection of gastric cancer was 90% (18/20) and 100% (24/24) in early and advanced gastric cancer, respectively, with an overall detection rate of 95% (42/44). Its accuracy for determination of tumor penetration depth was 89% (16/18) and 88% (21/24) in early and advanced gastric cancer, respectively, with an overall accuracy of 88% (37/42). Its accuracy for determination of lymph node metastasis was 90% (18/20) and 71% (17/24) in early and advanced gastric cancer, respectively, with an overall accuracy of 80% (35/44).
The 64 MDCT is a promising technique for the detection and preoperative staging of gastric cancer.
评估64排多层螺旋CT（MDCT）在胃癌诊断及分期中的准确性。
本研究经机构审查委员会批准，所有参与患者均签署知情同意书。44例胃癌患者（34例男性，10例女性；平均年龄57岁）术前行64排MDCT检查（SOMATOM Sensation 64；德国西门子医疗系统公司，福希海姆；层厚0.6mm，层间距5mm，进床/旋转速度23mm，螺距因子1.2，卷积核B30f，机架旋转速度0.5秒/圈）。通过口服8g泡腾颗粒使胃充盈。静脉注射100ml对比剂（4ml/s）后，采用团注追踪和自动触发技术确定动脉期和门静脉期，然后进行扫描。所有CT扫描图像均由2名放射科医生进行回顾性分析。根据TNM分类系统对每个肿瘤进行分期。所有患者均接受手术治疗。将CT结果与肿瘤浸润深度及区域淋巴结转移的组织学分期进行比较。
64排MDCT对早期胃癌的检出准确率为90%（18/20），对进展期胃癌的检出准确率为100%（24/24），总体检出率为95%（42/44）。其对肿瘤浸润深度的判断准确率在早期胃癌中为89%（16/18），在进展期胃癌中为88%（21/24），总体准确率为88%（37/42）。其对淋巴结转移的判断准确率在早期胃癌中为90%（18/20），在进展期胃癌中为71%（17/24），总体准确率为80%（35/44）。
64排MDCT是一种很有前景的胃癌检测及术前分期技术。
