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目的:研究16排螺旋CT三维成像(3D CT)包括表面遮盖法(SSD)、仿真胃镜(CTVG)在胃癌诊断中的价值。方法:123例胃癌患者(121例进展期胃癌,2例早期胃癌)均经胃镜活检病理证实,121例手术证实(2例进展期胃癌伴肝转移而未能手术)。使用GE Lightspeed Ultra 16排CT行全胃扫描,扫描条件层厚1.25 mm,1.375∶1,0.8 s/r,120 kV,300 mA,扫描总时间6~8 s。对123例胃癌用2种常用的成像方法检查,评价图像质量、病变检出率、Borrmann分型等,并与胃镜和手术结果比较。结果:16排CT的SSD和CTVG的图像质量均显示满意;SSD和CTVG的病变检出率分别为93.50%(115/123)、94.31%(116/123);进展期胃癌Borrmann分型的敏感度均为95.04%(115/121)。16排CT扫描克服了腹部呼吸运动伪影的影响,明显提高了三维图像质量。结论:16排CT三维成像大幅提高了图像质量和病变检出能力,为胃癌的术前准确评价提供了可信依据。
Objective: To study the value of 16-slice spiral CT three-dimensional imaging (3DCT) including surface covering method (SSD) and simulated gastroscope (CTVG) in the diagnosis of gastric cancer. Methods: 123 cases of gastric cancer (121 cases of advanced gastric cancer, 2 cases of early gastric cancer) were confirmed by gastroscopy biopsy, 121 cases confirmed (2 cases of advanced gastric cancer with liver metastasis and failed to surgery). The total area of 1.25 mm, 1.375: 1, 0.8 s / r, 120 kV and 300 mA was scanned with GE Lightspeed Ultra 16-slice CT. The total scan time was 6-8 s. 123 cases of gastric cancer with two kinds of imaging methods commonly used to check and evaluate the image quality, the detection rate of lesions, Borrmann classification, and compared with endoscopy and surgical results. Results: The image quality of SSD and CTVG in 16-slice CT was satisfactory. The detection rates of SSD and CTVG were 93.50% (115/123) and 94.31% (116/123), respectively. The sensitivity of Borrmann typing in advanced gastric cancer The degrees were 95.04% (115/121). The 16-slice CT scan overcomes the effects of abdominal respiratory motion artifacts and significantly improves the three-dimensional image quality. Conclusion: 16-slice CT three-dimensional imaging greatly improves the image quality and lesion detection ability, which provides a credible basis for accurate preoperative evaluation of gastric cancer.