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目的评估64排螺旋CT增强鉴别对胃肠道上皮内瘤和早期癌的诊断效果。方法回顾性研究28例接受手术和CT鉴别的胃癌患者临床资料。CT鉴别结果均为肿瘤部位,胃壁的厚度,肿瘤的扩展,N1和N2淋巴结受累情况。比较螺旋CT鉴别和病理诊断结果。结果螺旋CT鉴别正确分期为20例(71.4%)。12例患者(42.9%)胃壁厚度<2 cm,其中10例(83.3%)浆膜受累,其余2例患者胃壁厚度分别为0.5和1.0 cm。16例(57.1%)患者胃壁厚度>2cm,且均有浆膜受累。CT评估胰腺侵入的敏感性、特异性和准确性分别为100.0%,73.9%和78.6%。螺旋CT评估浆膜受累有(无)邻近器官浸润的敏感性,特异性和准确性达到96.2%,100.0%和96.4%。螺旋CT评估病理淋巴结的敏感性、特异性和准确性分别为73.1%、50.0%和71.4%。结论螺旋CT是胃癌术前分期和早期胃癌诊断的优选技术。
Objective To evaluate the diagnostic value of 64-slice spiral CT in differential diagnosis of gastrointestinal intraepithelial neoplasia and early cancer. Methods The clinical data of 28 gastric cancer patients undergoing surgery and CT were retrospectively studied. The results of CT identification were the tumor site, the thickness of the gastric wall, the expansion of the tumor, and the involvement of N1 and N2 lymph nodes. Comparison of spiral CT identification and pathological diagnosis. Results The correct staging of spiral CT was 20 cases (71.4%). Twelve patients (42.9%) had gastric wall thickness <2 cm, of which 10 (83.3%) had serosal involvement and the remaining 2 patients had gastric wall thicknesses of 0.5 and 1.0 cm, respectively. 16 cases (57.1%) patients with gastric wall thickness> 2cm, and all have serosa involvement. The sensitivity, specificity and accuracy of CT in evaluating pancreatic invasion were 100.0%, 73.9% and 78.6%, respectively. The sensitivity, specificity and accuracy of spiral computed tomography in assessing the infiltration of adjacent organs with or without serosal invasion were 96.2%, 100.0% and 96.4%. The sensitivity, specificity and accuracy of spiral computed tomography in assessing pathologic lymph nodes were 73.1%, 50.0% and 71.4%, respectively. Conclusion Spiral CT is a preoperative staging of gastric cancer and early gastric cancer diagnosis of the preferred technology.