摘要
目的评价不使用低张药进行64层螺旋CT胃癌术前检查的效果。资料与方法前瞻性研究256例胃癌患者的CT资料,评价图像伪影、胃充盈效果、胃癌检出、术前CTT分期、进展期胃癌大体分型、病变胃壁与非病变胃壁形态及厚度变化,并与病理结果进行对照。结果 CT图像无胃蠕动伪影。早期胃癌胃充盈优良率为93.9%(31/33),进展期胃癌为76.3%(170/223),两者差异有统计学意义(χ2=5.34,P<0.05)。进展期胃癌的检出率为98.7%(220/223),早期胃癌为45.5%(15/33),两者差异有统计学意义(χ2=108.04,P<0.05)。术前CTT分期对胃癌的诊断准确率为77.6%(135/174),进展期胃癌大体分型的诊断准确率为91.3%(126/138)。早期胃癌病变形态及厚度变化的发生率为33.3%(5/15),进展期胃癌为0.9%(2/220),两者差异有统计学意义(χ2=51.08,P<0.05)。正常胃底、胃体和胃窦形态及厚度变化的发生率分别为2.8%(5/179)、22.7%(30/132)和82.2%(88/107),三者差异有统计学意义(χ2=207.72,P<0.05)。结论使用64层螺旋CT进行胃癌术前检查,不用低张药物也能获得满意的检查效果。非低张多期增强CT扫描能动态观察胃壁变化。
Purpose To evaluate the effect of 64-slice spiral CT without hypotonic drug on gastric cancer before operation. Material and Methods CT data of 256 patients with gastric cancer were retrospectively analyzed. Image artifacts, gastric filling effect, detection of gastric cancer, preoperative CT staging of advanced gastric carcinoma, the general classification, morphology and thickness changes of gastric wall with lesions and gastric wall without lesions were evaluated, and compared with pathology. Results There was no gastric peristalsis artifact of CT image. Stomach filling rate was demonstrated higher in early gastric cancer （93.9%, 31/33） than that ill advanced gastric cancer （76.3%, 170/223） 0（2=5.34, P〈0.05）. Detection rate was observed higher in advanced gastric cancer （98.7%, 220/223） than that in early gastric cancer （45.5%, 15/33） 0（2 108.04, 1~〈0.05）. The diagnosis accuracy rate of preoperative CT T stage of gastric cancer was 77.6% （135/174）, and advanced gastric cancer diagnosis accuracy rate was 91.3% （126/138）. Morphology and thickness changes was investigated more frequently in early gastric cancer lesions （33.3%, 5/15） than that in advanced gastric cancer （0.9%, 2/220） 0（-＇=51.08, P^0.05）. The thickness change rate of normal stomach bottom, gastric body and gastric antrum form was 2.8% （5/t 79）, 22.7% （30/132） and 82.2% （88/107） （Z-^-207.72, P〈0.05）, respectively. Conclusion 64-slice spiral CT can obtain satisfactory inspection effect without low tension of drug for carcinoma before operation, and the no-low tension of multiphasic contrast-enhanced CT scan can dynamically observe changes of gastric wall.
出处
《中国医学影像学杂志》
CSCD
北大核心
2013年第3期210-213,217,共5页
Chinese Journal of Medical Imaging
基金
辽宁省自然科学基金项目(20092121)
