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目的探讨气钡双重造影与多排螺旋CT诊断胃癌的临床价值。方法回顾性分析92例胃癌患者的临床资料,所有患者均采用气钡双重造影与多排螺旋CT诊断,比较两种方法的确诊率、影响学表现检出率及多排螺旋CT临床分期准确率。结果多排螺旋CT确诊率为90.22%,显著高于气钡双重造影的80.43%,差异具有统计学意义(P<0.05)。多排螺旋CT黏膜病变、软组织肿块、恶性龛影、胃壁增厚、食管下端变窄的影响学表现检出率与气钡双重造影比较,差异具有统计学意义(P<0.05)。多排螺旋CT分期结果与病理分期对照,Ⅰ期的准确率为58.33%(7/12),Ⅱ期的准确率为83.33%(20/24),Ⅲ期的准确率为83.72%(36/43),Ⅳ期的准确率为76.92%(10/13),总体准确率为79.35%(73/92)。结论气钡双重造影与多排螺旋CT对胃癌的诊断均有较高的临床价值,但多排螺旋CT的确诊率更高,与病理结果一致性较高,能够显示肿瘤侵袭程度,利于对胃癌进行分期判断,对治疗方案及手术方式的选择有积极的临床意义。
Objective To investigate the clinical value of double-contrast barium-bromide and multi-slice spiral CT in the diagnosis of gastric cancer. Methods The clinical data of 92 patients with gastric cancer were retrospectively analyzed. All the patients were diagnosed by double-contrast barium-double-angiography and multi-slice spiral CT. The diagnostic accuracy, the detection rate and the clinical staging accuracy of multi-slice spiral CT . Results The accuracy of MSCT was 90.22%, which was significantly higher than 80.43% of double barium-barium double contrast, the difference was statistically significant (P <0.05). The detection rate of mucosal lesion, soft tissue mass, malignant niche, thickening of gastric wall and narrowing of the lower esophagus in multi-detector row spiral CT were significantly different from those of double-contrast barium double contrast (P <0.05). The accuracy of stage Ⅰ was 58.33% (7/12), the accuracy of stage Ⅱ was 83.33% (20/24), and the accuracy of stage Ⅲ was 83.72% (36 / 43), the accuracy of stage Ⅳ was 76.92% (10/13), and the overall accuracy was 79.35% (73/92). Conclusions Barium double-contrast and multi-slice spiral CT have high clinical value in the diagnosis of gastric cancer, but the multi-slice spiral CT diagnosis rate is higher, consistent with the pathological results higher, can show the degree of tumor invasion, which is conducive to gastric cancer Staging to determine the treatment options and surgical options have a positive clinical significance.