Zhong Bao-yuan, Liu Yan-xiu, Huang Wen-feng, Liu Qing-quan, Liu Shao-qiang, Liu Yao
Department of Emergency Surgery, Gannan Medical College, Jiangxi Ganzhou, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Jul;15(7):706-9.
To explore the clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM staging assessment of gastric carcinoma.
A retrospective study was performed to review the 64-slice spiral 3-phase CT enhanced scanning of 120 patients with gastric cancer diagnosed by biopsy prior to operation and postoperative pathological reports. All the findings were reviewed by two senior radiologic diagnosticians separately and compared with pathological findings.
The accuracy of 64-slice spiral CT enhanced scan was 79.2%(95/120) for T staging, 66.7%(10/15) for T1, 66.7%(14/21) for T2, 84.0%(42/50) for T3, and 85.3%(29/34) for T4. For gastric wall with single layer and multiple layers, the accuracy of CT enhanced scanning was 59.4%(19/32) and 81.8%(72/88) for T staging, and the difference was statistically significant(P<0.05). The accuracy of 64-slice spiral CT enhanced scan was 73.9%(85/115) for N staging, 75.5%(37/49) for N0, 70.3%(26/37) for N1, 75.9%(22/29) for N2. The accuracy of 64-slice spiral CT enhanced scanning was 89.2% for M staging.
64-slice spiral CT 3-phase enhanced scanning can monitor the invasion, lymphatic metastasis, and distant metastasis of gastric cancer dynamically, which may become an important examination item for the preoperative evaluation of gastric cancer.
探讨64层螺旋CT三期增强扫描在胃癌术前TNM分期评估中的临床价值。
回顾性分析120例术前经活检确诊为胃癌患者的64层螺旋CT三期增强扫描及术后病理报告。所有结果由两位资深放射诊断医师分别复查，并与病理结果进行对比。
64层螺旋CT增强扫描T分期的准确率为79.2%（95/120），T1期为66.7%（10/15），T2期为66.7%（14/21），T3期为84.0%（42/50），T4期为85.3%（29/34）。对于单层和多层胃壁，CT增强扫描T分期的准确率分别为59.4%（19/32）和81.8%（72/88），差异有统计学意义（P<0.05）。64层螺旋CT增强扫描N分期的准确率为73.9%（85/115），N0期为75.5%（37/49），N1期为70.3%（26/37），N2期为75.9%（22/29）。64层螺旋CT增强扫描M分期的准确率为89.2%。
64层螺旋CT三期增强扫描可动态监测胃癌的侵犯、淋巴转移及远处转移情况，有望成为胃癌术前评估的重要检查项目。
