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目的利用16排螺旋CT双期增强扫描对胃癌进行T分期并与病理对照,确定多排螺旋CT(multi-detec-tor row CT,MDCT)在术前T分期中的作用。资料与方法经胃镜证实的62例患者(63个病灶),术前采用16排螺旋CT平扫和动脉期、门静脉期双期增强扫描,随后根据5 mm层厚横断面图像情况重组薄层动脉期和门静脉期多平面重组(multiplanar reconstruction,MPR)图像,由两名资深放射科医师共同完成T分期,术后与病理对照。结果 MDCT结合MPR技术后对胃癌的检出率为96.7%,其中对早期胃癌的检出率为66.7%,进展期胃癌的检出率为100%。胃癌的MDCT大体分型准确率为88.9%。63个胃癌MDCT术前T分期总体准确率为71.4%,其中早期胃癌准确率为33.3%,进展期胃癌准确率为75.4%。结论采用MPR后处理技术的MDCT配合动态增强扫描对进展期胃癌的检出、大体分型和T分期准确率明显提高。
Objective To evaluate the role of multi-detec- tor row CT (MDCT) in preoperative T-staging by using T helium staging and pathological comparisons of gastric cancer with double-staged 16-slice spiral CT. Materials and Methods 62 patients (63 lesions) confirmed by gastroscope were examined with 16-slice spiral CT scan and double-phase enhanced arterial phase and portal vein phase before operation, and then the thin-layer arteries were reconstructed according to the cross-sectional images of 5 mm thickness Period and portal venous multiplanar reconstructions (MPR) images by two senior radiologists to complete T staging, postoperative and pathological control. Results The detection rate of gastric cancer by MDCT combined with MPR was 96.7%. The detection rate of early gastric cancer was 66.7% and that of advanced gastric cancer was 100%. General classification of gastric cancer MDCT accuracy was 88.9%. The overall accuracy of preoperative T-staging in 63 gastric cancer patients was 71.4%, of which the accuracy rate of early gastric cancer was 33.3% and the accuracy rate of advanced gastric cancer was 75.4%. Conclusions The detection, general classification and T staging accuracy of MDCT combined with dynamic contrast-enhanced scanning using MPR post-processing technique in advanced gastric cancer were significantly improved.