Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
BMC Med Inform Decis Mak. 2010 Jun 9;10:33. doi: 10.1186/1472-6947-10-33.
There have been no reports discussing which imaging procedures are truly necessary before treatment of endoscopically-diagnosed early gastric cancer (eEGC). The aim of this pilot study was to show which imaging examinations are essential to select indicated treatment or appropriate strategy in patients with eEGC.
In 140 consecutive patients (95 men, 45 women; age, 66.4 +/- 11.3 years [mean +/- standard deviation], range, 33-90) with eEGC which were diagnosed during two years, the pre-treatment results of ultrasonography (US) and contrast-enhanced computed tomography (CT) of the abdomen, barium enema (BE) and chest radiography (CR) were retrospectively reviewed. Useful findings that might affect indication or strategy were evaluated.
US demonstrated useful findings in 13 of 140 patients (9.3%): biliary tract stones (n = 11) and other malignant tumors (n = 2). Only one useful finding was demonstrated on CT (pancreatic intraductal papillary mucinous tumor) but not on US (0.7%; 95% confidential interval [CI], 2.1%). BE demonstrated colorectal carcinomas in six patients and polyps in 10 patients, altering treatment strategy (11.4%; 95%CI, 6.1-16.7%). Of these, only two colorectal carcinomas were detected on CT. CR showed three relevant findings (2.1%): pulmonary carcinoma (n = 1) and cardiomegaly (n = 2). Seventy-nine patients (56%) were treated surgically and 56 patients were treated by endoscopic intervention. The remaining five patients received no treatment due to various reasons.
US, BE and CR may be essential as pre-treatment imaging examinations because they occasionally detect findings which affect treatment indication and strategy, although abdominal contrast-enhanced CT rarely provide additional information.
目前尚无报道讨论在治疗内镜诊断的早期胃癌（eEGC）之前哪些影像学检查真正必要。本初步研究旨在展示在 eEGC 患者中哪些影像学检查对于选择有指征的治疗或适当的策略是必要的。
对两年间诊断为 eEGC 的 140 例连续患者（95 例男性，45 例女性；年龄 66.4±11.3 岁[均值±标准差]，范围 33-90），回顾性分析腹部超声（US）和增强 CT、钡灌肠（BE）和胸部 X 线检查（CR）的术前结果。评估可能影响治疗指征或策略的有用发现。
US 在 140 例患者中发现 13 例有用发现（9.3%）：胆道结石（n=11）和其他恶性肿瘤（n=2）。仅在 1 例患者（胰腺导管内乳头状黏液瘤）的 CT 上发现有用发现，但 US 未见（0.7%；95%可信区间[CI]，2.1%）。BE 发现 6 例结直肠癌和 10 例息肉，改变了治疗策略（11.4%；95%CI，6.1-16.7%）。其中，仅在 CT 上发现 2 例结直肠癌。CR 发现 3 例相关发现（2.1%）：肺癌（n=1）和心脏扩大（n=2）。79 例（56%）患者接受了手术治疗，56 例患者接受了内镜干预。由于各种原因，其余 5 例患者未接受治疗。
US、BE 和 CR 可能是必要的术前影像学检查，因为它们偶尔会发现影响治疗指征和策略的发现，尽管腹部增强 CT 很少提供额外信息。
