| 张梦梅,杨泠,危春容,冯瑶杰,杨亚英,熊倩.CT浆膜高强化征鉴别诊断T3期与T4a期胃癌[J].中国医学影像技术,2019,35(9):1361~1364 |
| CT浆膜高强化征鉴别诊断T3期与T4a期胃癌 |
| CT serosa high enhancement sign in differentiating T3 from T4a gastric cancer |
| 投稿时间：2019-03-17 修订日期：2019-07-06 |
| DOI：10.13929/j.1003-3289.201903119 |
| 中文关键词: 胃肿瘤 浆膜高强化征 浆膜浸润 体层摄影术,X线计算机 |
| 英文关键词:gastric neoplasms serosa high enhancement sign serosa invasion tomography, X-ray computed |
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| 中文摘要: |
| 目的 探讨CT所示浆膜高强化征鉴别诊断T3期与T4a期胃癌的价值。方法 回顾性分析104例经手术病理证实的胃癌T3期或T4a期患者术前腹部三期增强扫描CT图像，观察并比较各期图像浆膜高强化征的出现率。以出现浆膜高强化征为诊断T4a期的标准，计算浆膜高强化征诊断T4a期胃癌的准确率、敏感度、特异度、阳性预测值和阴性预测值。结果 104例胃癌患者中，T3期34例，T4a期70例。浆膜高强化征判断T4a期胃癌的准确率、敏感度、特异度、阳性预测值及阴性预测值分别为77.88%（81/104）、81.43%（57/70）、70.59%（24/34）、85.07%（57/67）及64.86%（24/37）。T4a期胃癌动脉期、静脉期及实质期浆膜高强化征出现率分别为32.86%（23/70）、75.71%（53/70）、62.86%（44/70），动脉期与静脉期（P<0.001）、动脉期与实质期（P=0.001）间差异有统计学意义，静脉期与实质期之间差异无统计学意义（P=0.143）。结论 浆膜高强化征诊断胃癌T4a期具有较高准确率、敏感度及特异度，可用于判断胃癌浆膜受侵，推荐在静脉期或实质期观察该征象。 |
| 英文摘要: |
| Objective To explore the value of serosa high enhancement sign in differentiating T3 and T4a gastric cancer. Methods Abdominal three-phase enhanced CT images of 104 patients with stage T3 or T4a gastric cancer confirmed by operation and pathology were analyzed retrospectively. The occurrence rate of serosa high enhancement sign in each stage was observed and compared. Using serosa high enhancement sign as the criterion for diagnosis of T4a stage gastric cancer,its accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Results Among 104 patients, 34 were found with T3 stage and 70 were T4a stage gastric cancer. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of serosa high enhancement sign in diagnosis of stage T4a gastric cancer was 77.88% (81/104), 81.43% (57/70), 70.59% (24/34), 85.07% (57/67) and 64.86% (24/37), respectively. The occurrence rate of serosa high enhancement sign in arterial phase, venous phase and delayed phase of T4a gastric cancer was 32.86% (23/70), 75.71% (53/70) and 62.86% (44/70), respectively. There was significant difference of occurrence rates between arterial phase and venous phase (P<0.001), also between arterial phase and delayed phase (P=0.001), but no significant difference was found between venous phase and delayed phase CT images (P=0.143). Conclusion Serosa high enhancement sign on enhance CT has relatively high accuracy, sensitivity and specificity for diagnosis of T4a gastric cancer, which can be used to judge the serosa invasion of gastric cancer. It is recommended to observe this sign in venous or delayed phase. |
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