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64层螺旋CT扫描在食管癌术前分期中的诊断及应用价值

[Diagnostic and application value of 64-slice spiral CT scanning in preoperative staging of esophageal cancer].

作者信息

Cheng Zhu-zhong, Yang Nin-jing, Xi Xiao-qiu, Zhao Ke, Hu Shi-bo, Xu Guo-hui, Ren Jing, Zhou Peng

机构信息

Department of Imaging, Sichuan Cancer Hospital, Chengdu 610041, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2011 Dec;33(12):929-32.

Abstract

OBJECTIVE

To investigate the diagnostic and application value of pre-operative 64-slice spiral CT evaluation in operation selection for esophagus cancer.

METHODS

Multi-slice computed tomography (MSCT) was conducted in 50 patients with esophageal cancer before operation, using the work station for after-treatment to get CT virtual endoscopy (CTVE), multiplanar reconstruction (MRP), shaded surface display (SSD) and Raysum images, and combined with the transect images to record the preoperative MSCT staging and to predict the operation scheme, and compared with the postoperative pathological staging and the actual operational plan.

RESULTS

The diagnostic sensitivity of MSCT for preoperative T staging was 100.0% (50/50), while the N staging was 80.0% (16/20). According to the MSCT prediction, the resection rate of esophageal cancer was 96.0% (48/50). Through the preoperative MSCT evaluation, the accuracy of CT-TNM stage was 90.0%, highly consistent with the pathological TNM stage (Kappa = 0.811, P < 0.05).

CONCLUSIONS

MSCT can effectively display the shape, size and position of the tumor, determine the tumor invasion range, lymph node metastasis and distant metastasis, etc., make preoperative evaluation for esophagus cancer patients and provide evidence for clinicians to predict the operation scheme for esophagus cancer.

摘要

目的

探讨术前64层螺旋CT评估在食管癌手术选择中的诊断及应用价值。

方法

对50例食管癌患者术前行多层螺旋CT(MSCT)检查,利用后处理工作站获得CT仿真内镜(CTVE)、多平面重建(MPR)、表面阴影显示(SSD)及容积再现(Raysum)图像,并结合横断面图像记录术前MSCT分期,预测手术方案,与术后病理分期及实际手术方案进行对比。

结果

MSCT对术前T分期的诊断敏感度为100.0%(50/50),N分期为80.0%(16/20)。根据MSCT预测,食管癌切除率为96.0%(48/50)。经术前MSCT评估,CT-TNM分期准确率为90.0%,与病理TNM分期高度一致(Kappa = 0.811,P < 0.05)。

结论

MSCT能有效显示肿瘤的形态、大小及位置,确定肿瘤浸润范围、淋巴结转移及远处转移等情况,对食管癌患者进行术前评估,为临床医生预测食管癌手术方案提供依据。

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