胃癌的双倾斜多层螺旋CT仿真胃镜检查
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孙清荣

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Examination of gastric carcinoma with CT virtual gastroscopy using bitilted CT scanning
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    目的 探讨用双倾斜多层螺旋CT扫描仿真胃镜(CTVG)诊断胃癌的方法及其价值。
    方法 使用16排螺旋CT对40例受试者进行双倾斜CT扫描CTVG检查。口服产气粉后分别取仰卧位左右前斜位躺在扫描床上扫描。用GE公司虚拟解剖软件行CTVG及多平面重建(MPR)后处理。
    结果 双倾斜CT扫描后CTVG及MPR能清楚显示靶器官的正常解剖结构和病变的部位、大小、形态及其侵犯范围。CTVG结合MPR显示胃癌的影像表现有胃壁增厚、软组织肿块、胃腔狭窄、癌性溃疡、邻近组织侵犯、淋巴结或远处转移。以胃镜检查为金标准,全组患者的诊断准确率为92.5%,敏感度为93.3%,特异度为90.0%,阳性预告值为96.7%,阴性预告值为81.8%。
    结论 双倾斜CT扫描仿真胃镜技术是一种安全、可靠、无创的检查方法,可作为胃镜检查的有效补充手段,具有较好的临床应用价值。

    Abstract:

    Abstract:Objective To investigate the procedure, imaging features and clinical significance of CT virtual gastroscopy(CTVG) in the diagnosis of gastric carcinoma using bitilted CT scanning.
    Methods Thirty patients and ten normal volunteers had bitilted CT scan using helical CT(GE lightspeed 16 CT). The patients and yolunteers were given bubblemaking powder by mouth and placed in a supine position on the CT table. CTVG and MPR images were obtained using the virtual dissection and reform of GE.
    Results The appearances of the inner lesion and normal wall of the stomach on CTVG were similar to those on fiberoptic gastroscopy. The CTVG and MPR features of gastric cancer were focal or diffuse mural thickening, soft tissue mass, stenosis of stomach, cancerous ulcer, infiltration to adjacent tissues, and lymph node and distant metastases. In comparison with fiberoptic gastroscopy (as the gold standard), CTVG showed a diagnostic accuracy of 92.5%,a sensitivity of 93.3%, a specificity of 90.0%, a positive prediction value of 96.7%, and a negative prediction value of 81.8%.
    Conclusions CTVG is a safe, reliable, noninvasive method for demonstrating the structure of normal and abnormal stomach, and is a good complementory method to conventional fiberoptic gastroscopy.

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戚跃勇, 邹利光, 戴书华, 孙清荣, 陈轶, 陈林.胃癌的双倾斜多层螺旋CT仿真胃镜检查[J].中国普通外科杂志,2007,16(9):14-.
DOI:10.7659/j. issn.1005-6947.2007.09.014

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  • 收稿日期:2007-01-14
  • 最后修改日期:2007-06-11
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  • 在线发布日期: 2007-09-25