Karakoyun R, Demirci E, Karakoyun M, Karakaş B, Gündüz U, Sener Z, Gülenay S, Erol B, Sağtaş E
Department of Surgery Antalya Training and Research Hospital Antalya, Turkey -
Minerva Chir. 2014 Jun;69(3):129-40. Epub 2014 Apr 15.
The aim of this study was to evaluate the reliability of thin-slice hydro-multidetector row computed tomography (MDCT) in assessing resectability and lymph node staging of gastric cancer.
Sixty-one patients (37 males, 24 females; mean age 61 years) with gastric cancer, and whose surgery was planned, underwent preoperative abdominopelvic hydro-MDCT at slice thickness of 5 mm. We evaluated the tumor stage, depth of tumor invasion into the gastric wall, metastasis of lymph node, and presence/absence of distant metastases on the CT images produced with multiplanar reconstruction (MPR) and hydro-CT technique. The results were compared with pathological and surgical findings. Diagnostic accuracy was also analyzed.
Of 61 patients with gastric cancer, 6 (14%) were inoperable, 45 (68%) were advanced stage, and 10 (16%) were early stage gastric cancer patients. The detection rate of the primary tumor was 97% for MDCT; the overall accuracy of MDCT in the determination of the depth of invasion and serosal involvement when compared with pathological staging were 84% and 95%, respectively; the overall accuracy rate in lymph node staging was 73.5%.
MDCT can improve the accuracy of preoperative T and N staging of gastric cancer and will contribute to treatment strategies for patients with advanced stage gastric cancer.
本研究旨在评估薄层水充盈多层螺旋计算机断层扫描（MDCT）在评估胃癌可切除性及淋巴结分期方面的可靠性。
61例计划接受手术的胃癌患者（男性37例，女性24例；平均年龄61岁）接受了术前腹部盆腔水充盈MDCT检查，扫描层厚为5毫米。我们通过多平面重建（MPR）和水充盈CT技术生成的CT图像评估肿瘤分期、肿瘤侵犯胃壁的深度、淋巴结转移情况以及有无远处转移。将结果与病理及手术结果进行比较。同时分析诊断准确性。
61例胃癌患者中，6例（14%）无法手术，45例（68%）为进展期，10例（16%）为早期胃癌患者。MDCT对原发肿瘤的检出率为97%；与病理分期相比，MDCT判断肿瘤侵犯深度及浆膜受累情况的总体准确率分别为84%和95%；淋巴结分期的总体准确率为73.5%。
MDCT可提高胃癌术前T和N分期的准确性，有助于晚期胃癌患者的治疗策略制定。
