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超声造影在胃癌术前T分期中的诊断价值

[Diagnostic value of contrast-enhanced ultrasonography in preoperative T-staging of gastric cancer].

作者信息

Cui Jian, Yang Yong-ming, Ding Li-jun, Ouyang Hong, Ye Huai-song, Ruan Hua-juan, Huang Pin-tong, Zheng Zhi-qiang

机构信息

Department of Gastrointestinal Surgery, Lin'an Municipal People's Hospital, Zhejiang, Lin'an, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2010 Feb;13(2):141-4.

Abstract

OBJECTIVE

To investigate the diagnostic value of contrast-enhanced ultrasonography (CEUS) in preoperative T-staging of gastric cancer.

METHODS

A sulfur hexafluoride-filled microbubble ultrasound contrast agent and a continuous real-time imaging technique of contrast pulse sequencing were used. Normal gastric wall was examined by CEUS in 8 healthy volunteers and the results were compared with the findings on multislice computed tomography. Sixty-two patients with gastric cancer proved by biopsies who received preoperative CEUS examination were involved in this study, and the CEUS result was compared with postoperative pathological findings.

RESULTS

The normal gastric wall presented a one-layer structure in the portal venous phase and a three-layer structure in the arterial and equilibrium phase including a slightly hyper-enhanced inner layer, a hypo-enhanced intermediate layer, and a markedly hyper-enhanced outer layer, which corresponded histologically to the mucosal, submucosal, and muscular-serosal layer, respectively. The accuracy of transabdominal ultrasonography and CEUS in determining the T stage of gastric cancer was 72.9% and 88.1% respectively, and the difference was statistically significant (chi(2)=4.37, P=0.036).

CONCLUSIONS

CEUS shows the normal gastric wall as a one- or a three-layer structure, which provides a theory base for CEUS in preoperative T-staging of gastric cancer. CEUS is a useful diagnostic method for preoperative T-staging of gastric cancer.

摘要

目的

探讨超声造影(CEUS)在胃癌术前T分期中的诊断价值。

方法

采用六氟化硫微泡超声造影剂及对比脉冲序列连续实时成像技术。对8名健康志愿者行CEUS检查正常胃壁,并将结果与多层螺旋CT检查结果进行比较。本研究纳入62例经活检证实为胃癌且术前行CEUS检查的患者,将CEUS结果与术后病理结果进行比较。

结果

正常胃壁在门静脉期呈单层结构,在动脉期和平衡期呈三层结构,包括轻度高增强的内层、低增强的中层和明显高增强的外层,分别与组织学上的黏膜层、黏膜下层和肌浆膜层相对应。经腹超声和CEUS判断胃癌T分期的准确率分别为72.9%和88.1%,差异有统计学意义(χ2=4.37,P=0.036)。

结论

CEUS显示正常胃壁为单层或三层结构,为CEUS在胃癌术前T分期中的应用提供了理论依据。CEUS是胃癌术前T分期的一种有用的诊断方法。

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