摘要
目的:探究64排螺旋CT对胃癌淋巴结转移的诊断价值及诊断准确率的影响,为临床诊治提供理论参考。方法:收集2016年1月—2018年10月复旦大学附属闵行医院收治的82例术后病理学检查证实的胃癌患者及其影像学资料进行研究,采用64排螺旋CT进行检查,以术后病理学检查结果作为金标准。比较转移性淋巴结和非转移性淋巴结长径、短径、短径/长径,以及平扫期、动脉期、门静脉期、平衡期值。对比CT检查结果与手术病理学检查结果,分析CT扫描与术后病理N分期的情况。结果:82例患者中,淋巴结转移60例,无淋巴结转移22例;术中取出淋巴结574枚,其中转移性淋巴结401枚,非转移性淋巴结173枚。转移性淋巴结短径、短径/长径,以及平扫期、动脉期、门静脉期、平衡期值均大于非转移性淋巴结,差异有统计学意义(P<0.05),长径值差异无统计学意义(P>0.05)。CT诊断符合率为84.15%(69/82),特异度为81.25%(13/16),灵敏度为84.85%(56/66),与术后病理学结果比较差异无统计学意义(P>0.05)。与术后病理N分期比较,CT诊断N0期准确率为79.41%(27/34),N1期准确率为75.00%(6/8),N2期准确率为76.92%(10/13),N3a期准确率为81.25%(13/16),N3b期准确率为72.72%(8/11),总准确率为78.05%(64/82)。结论:64排螺旋CT应用在胃癌淋巴结转移的诊断检查中,特异度、灵敏度及N分期诊断准确率均比较高,具有较高的诊断价值。
Objective:To explore the diagnostic value and diagnostic accuracy of 64-slice spiral CT on lymph node metastasis of gastric cancer,and provide theoretical reference for clinical diagnosis and treatment.Methods:A total of 82 cases of gastric cancer patients admitted to Minhang Hospital,Fudan University from Jan.2016 to Oct.2018 and their imaging data were selected for study.64-slice spiral CT was used for examination,and the postoperative pathological examination results were taken as the gold standard.The length,short diameter,short/long diameter of metastatic and non-metastatic lymph nodes were compared,as well as the values of plain,arterial,portal,and equilibrium phases.CT examination results and surgical pathological results were compared to analyze the CT scan and postoperative pathological N stages.Results:Among the 82 patients,60 had lymph node metastasis and 22 had no lymph node metastasis.During the operation,574 lymph nodes were removed,including 401 metastatic lymph nodes and 173 non-metastatic lymph nodes.The values of short diameter,short diameter/long diameter of metastatic lymph nodes and the values of scan stage,arterial stage,portal vein stage and equilibrium stage were all greater than those of non-metastatic lymph nodes,and the difference was statistically significant(P<0.05),while the difference in length diameter was not statistically significant(P>0.05).The CT diagnostic coincidence rate was 84.15%(69/82),specificity 81.25%(13/16),and sensitivity 84.85%(56/66),and the difference was not statistically significant(P>0.05).Compared with postoperative pathological N staging,CT diagnosis accuracy of N0 stage was 79.41%(27/34),N1 stage 75.00%(6/8),N2 stage 76.92%(10/13),N3a stage 81.25%(13/16),N3b stage 72.72%(8/11),and total accuracy 78.05%(64/82).Conclusion:64-slice spiral CT is of high diagnostic value in the diagnosis and examination of lymph node metastasis of gastric cancer.
作者
陶华
申晋疆
TAO Hua;SHEN Jinjiang(Department of Radiology,Minhang Hospital,Fudan University,Shanghai 201100,China)
出处
《肿瘤影像学》
2020年第3期314-318,共5页
Oncoradiology
关键词
CT
胃癌
淋巴结转移
诊断
准确率
CT
Gastric cancer
Lymph node metastasis
Diagnosis
Accuracy
