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目的:通过与双对比上消化道钡餐(UGI)比较,研究多层CT胃镜(CTG)包括仿真胃镜(CTVG)和透明再现(TR)在胃癌术前诊断中的作用。方法:以手术病理检查结果为标准,分别计算CTVG、表面遮盖显示(SSD)、空气铸型成像(ACI)、Ray sum和上消化道钡餐(UGI)5种技术检出早期和进展期胃癌的准确率以及进展期胃癌Borrmann分型的准确率,分别比较CTVG、SSD、ACI、Ray sum和TR与UGI的结果。结果:CTVG检出早期和进展期胃癌的准确率与UGI相近(P>0.05),但SSD、ACI、Ray sum和TR均明显低于UGI(P<0.05)。CTVG胃癌Borrmann分型的准确率明显高于UGI(P<0.05),而Solid、Air和Ray sum的分型准确率则明显低于UGI(P<0.05),TR的分型准确率仅稍低于UGI,但差异无显著意义。结论:包括CTVG和TR在内的多层CT胃镜是术前评价胃癌的一种有价值的方法,CTVG可替代UGI来检测胃癌的病灶,SSD、ACI和Ray sum结合使用提高其诊断胃癌的价值。
OBJECTIVE: To investigate the role of multi-slice CT endoscopy (CTG), including simulated gastroscopy (CTVG) and transparent reconstruction (TR), in the preoperative diagnosis of gastric cancer by comparing with the double contrast upper digestive barium meal (UGI) Methods: According to the results of surgical pathology, CTVG, SSD, ACI, Ray sum and UGI were used to detect early and advanced gastric cancer Accuracy and the accuracy of Borrmann classification of advanced gastric cancer were compared with CTVG, SSD, ACI, Ray sum and TR and UGI results. Results: The accuracy rate of CTVG in detection of early and advanced gastric cancer was similar to that of UGI (P> 0.05), but SSD, ACI, Ray sum and TR were significantly lower than those of UGI (P <0.05). The accuracy of Borrmann classification of CTVG gastric cancer was significantly higher than that of UGI (P <0.05), but the accuracy of classification of Solid, Air and Ray sum was significantly lower than that of UGI (P <0.05). The accuracy of TR typing was only slightly lower In UGI, but no significant difference. CONCLUSIONS: Multi-slice CT endoscopy including CTVG and TR is a valuable method for the preoperative evaluation of gastric cancer. CTVG can replace the UGI to detect gastric cancer lesions. The combined use of SSD, ACI and Ray sum can improve the value of gastric cancer diagnosis .