Li Xue-dan, Cui Ling-ling, Cui Li-he, Liu Yi, Ren Ke, Xu Ke
Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Jan;16(1):48-51.
To explore the value of multidetector CT on aiding intraoperative judgement of serosal invasion of gastric cancer.
Clinical data of 206 cases of gastric cancer undergoing radical surgery in the First Hosptial of China Medical University from August 2009 to June 2011 were analyzed retrospectively. Preoperative CT findings and intraoperative judgement of serosal invasion in gastric cancer were compared with pathological results in order to investigate their values.
The sensitivity and specificity of preoperative CT findings and intraoperative judgement of serosal invasion were 88.5%, 81.5% and 98.9%, 61.3%, respectively. The accuracy of preoperative CT in diagnosing serosal invasion was higher than that of intraoperative judgement, while the difference was not statistically significant (84.5% vs. 77.2%, P=0.060). The rates of serosal invasion of normal type, reactive type, nodular type, tendonoid type and color-diffused type were 0 (0/29), 2.5% (1/40), 40.5% (15/37), 59.2% (29/49), and 82.4% (42/51) respectively. The accuracy of preoperative CT in diagnosing serosal invasion of gastric cancer with tendonoid type was higher than that of intraoperative judgement, and the difference was statistically significant (61.2% vs. 87.8%, P=0.002).
Multidetector CT plays an important role in aiding intraoperation judgement of serosal invasion of gastric cancer. For gastric cancer with tendonoid and color-diffused macroscopic serosal appearance, surgeons should pay attention to the value of preoperative CT findings.
探讨多排螺旋CT辅助判断胃癌浆膜侵犯情况的价值。
回顾性分析2009年8月至2011年6月在中国医科大学附属第一医院接受根治性手术的206例胃癌患者的临床资料。将术前CT表现及术中对胃癌浆膜侵犯的判断与病理结果进行比较，以研究其价值。
术前CT表现及术中对浆膜侵犯判断的敏感度分别为88.5%、81.5%，特异度分别为98.9%、61.3%。术前CT诊断浆膜侵犯的准确率高于术中判断，差异无统计学意义（84.5%对77.2%，P = 0.060）。正常型、反应型、结节型、腱样型及弥漫型胃癌的浆膜侵犯率分别为0（0/29）、2.5%（1/40）、40.5%（15/37）、59.2%（29/49）及82.4%（42/51）。术前CT诊断腱样型胃癌浆膜侵犯的准确率高于术中判断，差异有统计学意义（61.2%对87.8%，P = 0.002）。
多排螺旋CT在辅助术中判断胃癌浆膜侵犯情况中具有重要作用。对于具有腱样型及弥漫型大体浆膜表现的胃癌，外科医生应重视术前CT表现的价值。
