摘要
目的评价多层螺旋CT(MDCT)及其多平面重建(MPR)技术在贲门癌术前分期的价值。方法对55例贲门癌患者行术前双期增强多层螺旋CT扫描,将横断面图像和MPR图像的分期结果与手术及病理结果对照。结果横断面、MPR图像总的分期准确率为63.64%和61.82%,两者无显著性差异(P>0.05),两者对Ⅲ期和Ⅳ期的准确率均为60.98%。横断面、MPR图像对鉴别T2和T3的准确率分别为77.78%和84.44%,两者无显著性差异(P>0.05),横断面与MPR图像诊断T4的敏感性、特异性、准确率及阳性预测值、阴性预测值分别为66.67%,84.78%,81.82%,10.91%,92.86%和66.67%,89.13%,85.45%,10.91%,93.18%,两者无显著性差异(P>0.05)。N分类的敏感性、特异性、准确率及阳性预测值、阴性预测值分别为68.89%,80.00%,70.91%,56.36%,36.36%。诊断肝转移的准确率为100.00%,诊断腹膜、网膜转移的准确率为50.00%(2/4)。结论多层螺旋CT有助于贲门癌术前分期,特别是MPR图像使病变定位更直观,可提高T分期、N分期的信心。
Objective To evaluate the utility of multi-detector CT and muhlplanar reconstruction technique in the preoperative staging of cardia cancer. Methods We performed multi-detector CT（MDCT） in 55 patients with cardia cancer, the results of preoperative staging on transverse images and multiplanar reconstruction（MPR） images were correlated with pathologic findings. Results Overall accuracy of staging by transverse images and MPR images were 63.64 % and 61.82% ,respectlvely,with no statistical significance（P 〉0.05）. The accuracies of stage Ⅲ and stage Ⅳ by both images were 60.98% each. In T staglng,the accuracy of differentiation between T2 and T3 cancer were 77.78% and 84.44% ,respectlvely（P 〉0.05）. In T4 staging by both images,sensltlvity, specificity, accuracy, positive predictive value, and negative predictive value were 66.67 %, 84.78 %, 81.82 %, 10.91%, 92.86% and 66.67 %,89.13% ,85.45%, 10.91%, 93.18%, respectively （P 〉 0.05）. In N staging, sensitivity, specificity, accuracy, positive predictive value,and negative predictive value were 68.89%, 80.00%, 70.91%, 56.36%, 36.36%, respectively. Liver metastases were correct in 100.00 %,peritoneum and omentum metastases were correct in 50.00% （2/4）. Conclusion MDCT is a useful technique for preoperative staging of cardia cancer, especially, MPR images can increase confidence in the T-staging and N-staglng for showing lesions intuitively.
出处
《实用癌症杂志》
2005年第4期417-420,共4页
The Practical Journal of Cancer
