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目的 与胃钡餐造影 (GI)、纤维胃镜 (FG)及手术标本对照 ,明确螺旋CT(SCT)成像技术对溃疡型胃癌的诊断价值。资料与方法 经手术病理证实的 40例溃疡型胃癌行胃产气后SCT检查 ,其中 32例行胃气钡双重造影检查 ,2 6例有手术标本和胃镜录像。由 2位放射科医师对SCT及GI图像分别进行盲法阅读 ,评价病变的探测、Bor rmann分型及分析诊断可信度 ,阅片者间的一致度采用k检验。结果 40例溃疡性病变手术病理共检出 49个病灶 ,2位阅片者SCT各检出 47个 ,32例GI检查者 ,病理证实 40个溃疡病灶 ,2位阅片者GI各明确检出 16和 15个溃疡病灶。BorrmannⅡ、Ⅲ型癌的鉴别CT仿真胃镜 (CTVG)准确性为 92 .39%,GI准确性为 2 6 .92 %(P <0 .0 5 )。结论 SCT对胃部溃疡性病灶的显示及Borrmann分型优于GI。
OBJECTIVE: To evaluate the diagnostic value of spiral CT (SCT) imaging in the diagnosis of gastric ulcer gastric cancer (GI), gastroscopy (FG) and surgical specimens. Materials and Methods 40 cases of ulcerated gastric carcinoma confirmed by surgery and pathology were examined by gastroscopy after SCT. Among them, 32 cases underwent gastrogal barium double contrast examination and 26 cases underwent surgical gastroscopy and gastroscopy. Two radiologists performed blinded readings on SCT and GI images respectively to evaluate the detection of lesions, Borrmann classification and analysis of diagnostic credibility, and the consistency between readers was evaluated by k-test. Results Forty-four lesions were detected in 40 patients with ulcerative lesions. Among the 2 patients, 47 were detected by SCT, 32 were examined by GI, and 40 were confirmed by pathology. The GI readings of 2 readers were clearly detected 16 and 15 ulcer lesions. The accuracy of CT angiography (CTVG) was 92.39% for Borrmann Ⅱ and Ⅲ type of cancer, and the accuracy of GI was 26.92% (P <0.05). Conclusion SCT is superior to GI in the display of gastric ulcerative lesions and Borrmann classification.