黃娟 1 , 潘彥辰 2 , 周翔平 1 , 宋彬 1 , 姚晉 1
  • 1.四川大學(xué)華西醫(yī)院放射科（成都610041）;;
  • 2.四川省人民醫(yī)院（成都610041）;

目的 　 評(píng)價(jià)16排螺旋CT平掃及雙期增強(qiáng)掃描在胃癌診斷和TNM分期的價(jià)值，探討胃癌的影像學(xué)征象及其與手術(shù)病理檢查結(jié)果的關(guān)系。
方法 　以53例經(jīng)手術(shù)病理檢查證實(shí)為胃癌的患者為研究對(duì)象，分析其平掃、動(dòng)脈期及靜脈期掃描和多平面重建（MPR）圖像。
結(jié)果 　16排螺旋CT對(duì)胃癌T分期、N分期和M分期的準(zhǔn)確性分別為83.02%、80.00%和92.45%,對(duì)胃癌TNM分期總準(zhǔn)確性為84.91%。
結(jié)論 　利用16排螺旋CT 平掃及雙期增強(qiáng)掃描尤其是局部薄層重建、MPR和恰當(dāng)?shù)拇凹夹g(shù)，能較全面、準(zhǔn)確地進(jìn)行胃癌病灶的診斷和TNM分期，有助于臨床選擇恰當(dāng)?shù)氖中g(shù)切除范圍、手術(shù)方式和制定綜合治療方案。

引用本文： 黃娟,潘彥辰,周翔平,宋彬,姚晉. 16排螺旋CT胃癌診斷和CT-TNM分期的價(jià)值. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007, 14(6): 717-721. doi: 復(fù)制

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2. 　馮琦, 莊治國(guó), 許建榮. 多層螺旋CT判斷胃癌胃壁浸潤(rùn)深度的價(jià)值 [J]. 中國(guó)醫(yī)學(xué)影像技術(shù), 2006; 22(2)∶257.
3. 　Chen CY, Hsu JS, Wu DC, et al. Gastric cancer: preoperative local staging with 3D multi-detector row CT——correlation with surgical and histopathologic results [J]. Radilogy, 2007; 242(2)∶472.
4. 　Yajima K, Kanda T, Ohashi M, et al. Clinical and diagnostic significance of preoperative computed tomography findings of ascites in patients with advanced gastric cancer [J]. Am J Surg, 2006; 192(2)∶185.
5. 　Hur J, Park MS, Lee JH, et al. Diagnostic accuracy of multidetector row computed tomography in T- and N staging of gastric cancer with histopathologic correlation [J]. J Comput Assist Tomogr, 2006; 30(3)∶372.
6. 　潘自來(lái), 張歡, 張紹斌, 等. 多層螺旋CT胃癌術(shù)前TNM分期 [J]. 臨床放射學(xué)雜志, 2002； 21(8)∶614.
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8. 　Shiraga N, Kobayash S. Clinical application of multi-detector-row CT fox diagnosis of gastric cancer and degree of tumor invasion [J]. J Diagn Imaging, 2000; 3∶266.
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10. 　郭華, 高劍波, 楊學(xué)華, 等. 螺旋CT三期增強(qiáng)掃描對(duì)胃癌TNM分期的研究 [J]. 實(shí)用放射學(xué)雜志, 2003; 19(1)∶37.
11. 　Lee JH, Jeong YK, Kim DH, et al. Two-phase helical CT forde-tection of early gastric carcinoma: importance of the mucosal phase for analysis of the abnormal mucosal layer [J]. J Comput Assist Tomogr, 2000; 24(5)∶777.
12. 　Minami M, Kawauchi N, Ltai Y, et al. Gastric tumors: radioligic-pathologic correlation and accuracy of T staging of T staging with dynamic CT [J]. Radiology, 1992; 185(1)∶173.
13. 　胡建昆， 陳志新， 張波. 胃癌根治術(shù)中No.8淋巴結(jié)清掃的意義和技巧 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 14(9)∶560.
14. 　Kim AY, Kim HJ, Ha HK. Gastric cancer by multidetector row CT: preoperative staging [J]. Abdom Imaging, 2005; 30(4)∶465.
15. 　Fukuya T, Honda H, Hayashi T, et al. Lymph-node metastases: efficacy for dectection with helical CT in patients with gastric cancer [J]. Radiology, 1995; 197(3)∶705.
16. 　張曉鵬, 徐剛， 孫應(yīng)實(shí)， 等. 胃癌組與正常組螺旋CT淋巴結(jié)檢出率比較研究 [J]. 實(shí)用放射學(xué)雜志, 2002, 18(10)∶872.
17. 　左藤修, 川端建二, 伊藤博敏, 等. 胃癌種植轉(zhuǎn)移的CT評(píng)價(jià) [J]. 臨床放射線, 1999; 44(2)∶247.
18. 　王舒寶， 王俊. 胃癌復(fù)發(fā)與轉(zhuǎn)移的有關(guān)問(wèn)題及綜合治療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 13(1)∶9.
19. 　李月春, 伍曉汀. 胃癌病理學(xué)與生物學(xué)特征的關(guān)系 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 13(1)∶120.
20. 　Barry JD, Edwards P, Lewis WG, et al. Special interest radiology improves the perceived preoperative stage of gastric cancer [J]. Clin Radiol, 2002; 57(11)∶984.
  1. 1. 　李松年主編. 現(xiàn)代全身CT診斷學(xué) [M]. 北京： 中國(guó)醫(yī)藥科技出版社, 2001∶984～985.
  2. 2. 　馮琦, 莊治國(guó), 許建榮. 多層螺旋CT判斷胃癌胃壁浸潤(rùn)深度的價(jià)值 [J]. 中國(guó)醫(yī)學(xué)影像技術(shù), 2006; 22(2)∶257.
  3. 3. 　Chen CY, Hsu JS, Wu DC, et al. Gastric cancer: preoperative local staging with 3D multi-detector row CT——correlation with surgical and histopathologic results [J]. Radilogy, 2007; 242(2)∶472.
  4. 4. 　Yajima K, Kanda T, Ohashi M, et al. Clinical and diagnostic significance of preoperative computed tomography findings of ascites in patients with advanced gastric cancer [J]. Am J Surg, 2006; 192(2)∶185.
  5. 5. 　Hur J, Park MS, Lee JH, et al. Diagnostic accuracy of multidetector row computed tomography in T- and N staging of gastric cancer with histopathologic correlation [J]. J Comput Assist Tomogr, 2006; 30(3)∶372.
  6. 6. 　潘自來(lái), 張歡, 張紹斌, 等. 多層螺旋CT胃癌術(shù)前TNM分期 [J]. 臨床放射學(xué)雜志, 2002； 21(8)∶614.
  7. 7. 　Elia D, Zingarelli A, Palli D, et al. Hydro-dynamic CT preperative staging of gastric cancer: correlation with pathological finding: a prospective study of 107 cases [J]. Eur J Radiol, 1999； 10(12)∶1877.
  8. 8. 　Shiraga N, Kobayash S. Clinical application of multi-detector-row CT fox diagnosis of gastric cancer and degree of tumor invasion [J]. J Diagn Imaging, 2000; 3∶266.
  9. 9. 　Dong HL, Tac SS, Young TK. Spiral CT of the gastric carcinoma staging and enhancement pattern [J]. J Clin Imaging, 2001; 25∶32.
  10. 10. 　郭華, 高劍波, 楊學(xué)華, 等. 螺旋CT三期增強(qiáng)掃描對(duì)胃癌TNM分期的研究 [J]. 實(shí)用放射學(xué)雜志, 2003; 19(1)∶37.
  11. 11. 　Lee JH, Jeong YK, Kim DH, et al. Two-phase helical CT forde-tection of early gastric carcinoma: importance of the mucosal phase for analysis of the abnormal mucosal layer [J]. J Comput Assist Tomogr, 2000; 24(5)∶777.
  12. 12. 　Minami M, Kawauchi N, Ltai Y, et al. Gastric tumors: radioligic-pathologic correlation and accuracy of T staging of T staging with dynamic CT [J]. Radiology, 1992; 185(1)∶173.
  13. 13. 　胡建昆， 陳志新， 張波. 胃癌根治術(shù)中No.8淋巴結(jié)清掃的意義和技巧 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 14(9)∶560.
  14. 14. 　Kim AY, Kim HJ, Ha HK. Gastric cancer by multidetector row CT: preoperative staging [J]. Abdom Imaging, 2005; 30(4)∶465.
  15. 15. 　Fukuya T, Honda H, Hayashi T, et al. Lymph-node metastases: efficacy for dectection with helical CT in patients with gastric cancer [J]. Radiology, 1995; 197(3)∶705.
  16. 16. 　張曉鵬, 徐剛， 孫應(yīng)實(shí)， 等. 胃癌組與正常組螺旋CT淋巴結(jié)檢出率比較研究 [J]. 實(shí)用放射學(xué)雜志, 2002, 18(10)∶872.
  17. 17. 　左藤修, 川端建二, 伊藤博敏, 等. 胃癌種植轉(zhuǎn)移的CT評(píng)價(jià) [J]. 臨床放射線, 1999; 44(2)∶247.
  18. 18. 　王舒寶， 王俊. 胃癌復(fù)發(fā)與轉(zhuǎn)移的有關(guān)問(wèn)題及綜合治療 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 13(1)∶9.
  19. 19. 　李月春, 伍曉汀. 胃癌病理學(xué)與生物學(xué)特征的關(guān)系 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 13(1)∶120.
  20. 20. 　Barry JD, Edwards P, Lewis WG, et al. Special interest radiology improves the perceived preoperative stage of gastric cancer [J]. Clin Radiol, 2002; 57(11)∶984.