多层螺旋CT在胃肿瘤诊断中的应用研究

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目的 评价多层螺旋CT(MSCT)及其三维后处理技术在胃肿瘤诊断中的应用价值及影响因素。资料与方法 对 2 3例经上胃肠道钡餐造影 (GI)和胃镜检查诊断为胃肿瘤的患者行多层螺旋CT容积扫描 ,分别以多平面重建技术 (MPR)、3DCT技术 (包括SSD和RaySum)和CT仿真胃镜技术 (CTVG)进行后处理。分别评价所有重建影像显示胃肿瘤的能力以及影响因素 ,同时与上胃肠道造影及胃镜所见比较。结果  3DCT和CTVG诊断 2 3例胃肿瘤的敏感性和准确性分别为 95 .5 %和 85 .7%。以秩和检验比较 ,三维重建影像对胃肿瘤的整体显示效果接近GI和胃镜 ,但CTVG结合MPR影像对于评价粘膜下肿瘤的准确性则明显优于GI和胃镜。结论 综合运用MSCT及其多种后处理技术 ,在对胃肿瘤的检出、定位、分期等方面可发挥较大作用 ,是一种新的且具潜力的胃肿瘤检查方法 ,可作为传统检查方法的有益补充。在技术方面尚待进一步发展和完善。 Objective To evaluate the value and influencing factors of multi-slice spiral CT (MSCT) and its three-dimensional post-processing technique in the diagnosis of gastric tumors. Materials and Methods Multi-slice spiral CT volume scanning was performed on 23 patients diagnosed as gastric tumor by upper gastrointestinal barium meal (GI) and gastroscopy. The data were analyzed by multiplanar reconstruction (MPR), 3DCT (including SSD and RaySum) and CT simulated endoscopy (CTVG) for post-processing. We evaluated the ability of all reconstructed images to show gastric tumors and their influential factors, respectively, and compared them with those of upper gastrointestinal tract imaging and gastroscopy. Results The sensitivity and accuracy of 3DCT and CTVG in diagnosing 23 gastric tumors were 95.5% and 85.7%, respectively. Compared with GI and gastroscopy, the three-dimensional reconstructed images showed a similar overall effect to GI and gastroscope in terms of rank sum test. However, the accuracy of CTVG combined with MPR in evaluating submucosal tumors was significantly better than GI and gastroscope. Conclusion The comprehensive application of MSCT and its multiple post-processing techniques can play a significant role in the detection, localization and staging of gastric tumors. It is a new and potential method of gastric cancer examination and can be used as a traditional examination method Beneficial supplement. In terms of technology to be further developed and improved.
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