MSCT三期增强扫描和后处理技术对胃癌术前分期的评价

目的:探讨多层螺旋CT(MSCT)对胃癌的影像学诊断及其对术前分期的价值。方法:对49例胃癌患者行16层螺旋CT三期增强扫描后,用多平面重建(MPR)和CT仿真内镜(CTVE)等后处理技术对胃癌CT图像进行术前分期评价,并与术后病理分期对照,以术后病理分期为金标准。结果:MSCT T分期:T1期诊断准确率75.00%(6/8),T2、T3、T4期准确率分别为70.59%(12/17)、68.42%(13/19)、80.00%(4/5);N分期:N0期68.75%(11/16),N1期准确率为59.10%(13/22),N2期63.64%(7/11)。M分期中除1例左锁骨上淋巴结转移未行该部位的CT扫描不计入统计之列外,其余48例M分期的准确率为M0为90.91%(40/44),M1为50.00%(2/4)。结论:16层螺旋CT三期增强扫描结合多平面重建和CT仿真内镜等后处理技术对胃癌分期的准确率较高,值得临床推广。

Preoperative staging of gastric carcinoma with MSCT and post-processing techniques

Objective：To assess the accuracy of 16 multi-slice spiral computed tomography（MSCT） in the diagnosis and staging of gastric cancer.Methods：49 patients with histological proven gastric carcinoma underwent MSCT.The all raw data were transferred to Siemens leonardo workstation and were performed in post-processing including MPR and CTVE（CT virtual endoscopy）,each tumor was staged according to the TNM classification system.All patients were subsequently underwent surgery.Of MSCT were compared with histological staging.Results： In comparison with histological results,the accuracy T staging by MSCT was 75.00%（6/8） for T1,70.59% （12/17） for T2,68.42%（13/19） for T3,80.00%（4/5） for T4,respectively.The accuracy of N staging was 68.75%（11/16） for N0,59.10 %（13/22） for N1 and 63.64%（7/11） for N2,respectively.Except for one case with Virchow lymph node metastasis was not performed in chest scanning,the accuracy of M staging of all the remaining 48 patients was 90.91%（40/44） for M0 and 50.00%（2/4） for M1,respectively.Conclusion：The MSCT 3-phase enhanced scans in combination with post-processing techniques can achieve high accuracy in preoperative staging of gastric carcinoma.