摘要
目的 研究螺旋CT三维成像 (3DCT)包括仿真胃镜 (CTVG)、表面遮盖法 (SSD)和透明法 (Raysum)在胃癌诊断中的价值 ,并与上消化道钡餐 (UGI)比较。方法 43例胃癌患者 (3 7例进展期胃癌、6例早期胃癌 )均经手术病理证实 ,2位阅片者盲法阅片 ,对这 43例患者 4种成像方法 (CTVG、SSD、Raysum、UGI)的 172套图像分别进行如下 4方面的评价 :图像质量、伪影情况、病变的诊断可信度、Borrmann分型。根据手术和病理结果计算各种方法检出病变的敏感度和对进展期胃癌Borrmann分型的敏感度 ,将 3DCT的结果分别与UGI结果进行比较。结果 2位阅片者在CTVG、SSD、Raysum、UGI上的检出病灶敏感度分别为 98%、67%、60 %、84%与 98%、70 %、70 %、88% ,进展期胃癌Borrmann分型的敏感度分别为 76%、49%与 3 8%、49%与 78%、5 1%、3 5 %、43 %。 2位阅片者均认为CTVG、SSD、Raysum的图像质量与UGI类似 (P >0 0 5 ) ,CTVG和UGI在检出进展期胃癌 (诊断可信度≥ 3 )的敏感度方面差异无显著意义 (χ2 值为 0 5 0与 0 2 5 ,P >0 .0 5 ) ,而SSD、Raysum检出病灶的敏感度均低于UGI(P <0 0 5 ,χ2 值为 4 17、7 11与 5 14、4 17)。 2位阅片者均认为CTVG对胃癌Borrmann分型的敏感度高于UGI(χ2 值为 4 90与 4 92 ,P <0 .0 5 )
Objective To assess the role of three-dimensional (3D) CT imaging including CT virtual gastroscopy (CTVG), surface-shaded display (SSD), and Raysum Display in the evaluation of gastric carcinoma compared with upper gastrointestinal series (UGI).Methods In 43 histologically proved gastric carcinoma patients (37 advanced gastric carcinomas and 6 early gastric carcinomas), the results of CTVG and 3D CT imaging were compared to that of UGI. Two observers blindly evaluated images with all four techniques in terms of image quality, artifacts, diagnostic confidence, and Borrmann classification. Sensitivities of lesion detection and classification based on Borrmann classification of CTVG and 3D CT were determined by comparing them to surgical and histological findings. Results The lesion detection sensitivity of CTVG, SSD, Raysum, and UGI by two observers were 98%,67%,60%,and 84%, and 98%,70%,70%,and 88%, respectively. The Borrmann′s classification sensitivity by two obversers were 76%,49%,38%,and 49%, and 78%,51%,35%,and 43%, respectively. Overall image quality of CTVG, SSD, and Raysum was considered similar to that of UGI by both observers (P>0.05). There was no statistical significant difference for advanced lesion (with diagnostic confidence of 3 or above) in detection sensitivity between CTVG and UGI (χ 2=0.50 and 0.25, P>0.05), but the lesion detection sensitivity of SSD and Raysum display were lower than that of UGI(χ 2=4.17,7.11, and 5.14,4.17, P<0.05). Both observers considered the sensitivity of Borrmann′s classification of CTVG was statistically significant higher than that of UGI (χ 2=4.90 and 4.92, P<0.05). No statistically significant differences of sensitivity in classification between SSD, Raysum, and UGI were found. 6 cases of early gastric carcinoma were all detected only by CTVG although there was no statistically significant difference of early lesion detection sensitivity between CTVG and UGI (χ 2=2.25, P>0.05). Excess fluid remained in the stomach and patient respiratory movement during breath holds were the reasons causing severe artifacts (6.1%) that influenced the diagnostic evaluation. Conclusion The performance of CTVG was equivalent to UGI in the detection of advanced gastric carcinoma and superior to UGI in the Borrmann′s classification. CTVG has potential in the detection of early gastric carcinoma. The value of SSD and Raysum display was limited in the evaluation of gastric carcinoma when used alone clinically.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2002年第11期1021-1027,共7页
Chinese Journal of Radiology
基金
ECR 2 0 0 0 :EAR ECRResearchandEducationFundFellowshipGrant (欧洲放射学会研究与教育基金资助 )
江苏省卫生厅重点资助课题 (H 992 8)
关键词
CT
三维成像
传统钡餐
诊断
胃癌
比较研究
Tomography,X-ray computed
Stomach neoplasms
Image processing,computer-assisted
Evaluation studies
