摘要
目的：对经胃镜确诊为胃癌的病人，应用多层螺旋CT（Multi-slice computed tomography，MSCT）动态增强扫描检查后，行术前TNM分期，并与术后病理结果进行对照。分析胃癌的影像学征象，探讨MSCT在胃癌检出及术前TNM分期中的应用价值。方法：对本院2010年1月—2013年6月经胃镜及病理检查确诊为胃癌的患者152例，于术前1周内行MSCT检查。胃癌患者空腹于扫描前10～15 min肌注盐酸山莨菪碱20 mg、口服温开水800~1 000 mL后行MSCT扫描，根据病理提供的病变部位调整扫描体位。利用轴位和重建图像观察癌肿在胃壁内外浸润改变（T分期）、周围腹腔淋巴结有无转移（N分期）、周围脏器侵犯转移（M分期）。结果：CT表现为胃壁增厚、软组织肿块152例，病灶检出率为94％，T分期准确率为74.5%，N分期准确率为63.7％，M分期准确率为83.3%。结论：低张水充盈法MSCT动态增强扫描，能提高胃癌术前TNM分期的准确性，是有效判断局部浸润及远处转移的可靠的影像学检查方法。
Abstract
Objective: To assess the value of 16 slice spiral CT gastrography with hypotension and water filling of stomach for gastric cancer staging. Methods: From January 2010 to June 2013, 152 patients diagnosed as gastric cancer by gastroscopy and biopsy underwent multislice CT before surgery. MSCT examination was performed 1 week before operation. The patients were fasting and were given anisodamine hydrochloride 20 mg through muscular injection 10~15 min before scanning, after that 800~1 000 mL pure water was given orally. Scanning position was arranged according to the site of the lesion discovered by endoscopy and biopsy. The CT features of infiltration of the cancer within and outside the gastric wall(T staging), metastatic lymph nodes(N staging), metastases to adjacent organs(M staging) were observed on axial and reformatted images. Results: CT manifestation of thickening of gastric wall, soft tissue mass were seen in the 152 cases, lesion detection rate was 94%. Accurary of T staging was 74.5%. Accurary of N staging and M staging were 63.7% and 83.3% respectively. Conclusion: Contrast enhanced MSCT gastrography of water filling the stomach with hypotension is an effective examination which can raise up the accuracy of TNM staging before operation and also can accurately evaluate local infiltration and distal metastases.
关键词
胃肿瘤 /
体层摄影术 /
螺旋计算机
Key words
Stomach neoplasms /
Tomography /
spiral computed
陈志烈;王晓洲;李晓惠;杨景萍;张建清;张定义.
低张水充盈法16层螺旋CT对胃癌术前分期的诊断价值[J]. 中国临床医学影像杂志. 2013, 24(12): 858-860
CHEN Zhi-lie;WANG Xiao-zhou;LI Xiao-hui;YANG Jing-ping;ZHANG Jian-qing;ZHANG Ding-yi.
The value of 16 slice spiral CT gastrography with hypotension and water filling of stomach for gastric cancer staging[J]. Journal of China Clinic Medical Imaging. 2013, 24(12): 858-860
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