文章摘要

低剂量64排CT双期增强扫描在胃癌淋巴结转移评估中的应用价值

作者: 1刘文思, 1林承露, 1郭磊, 1吴菊华
1 六安市第二人民医院CT室,安徽 六安 237000
通讯: 刘文思 Email: 4966906@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.08.016

摘要

目的:分析低剂量64排CT双期增强扫描在胃癌淋巴结转移评估中的应用价值,为临床诊疗提供参考。方法:选取2015年2月至2019年5月六安市第二人民医院收治的胃癌患者40例进行研究,所有患者行低剂量64排CT双期增强扫描与常规剂量CT三期增强扫描,并将手术病理结果与CT检查结果进行比较。结果:低剂量64排CT双期增强扫描诊断胃癌淋巴结转移的敏感度为83.33%,特异度为90.00%,差异有统计学意义(P<0.05);常规剂量CT三期增强扫描诊断胃癌淋巴结转移的敏感度为62.50%,特异度为43.75%,差异有统计学意义(P<0.05);低剂量64排CT双期增强扫描对病理分期N0-N3b的准确度依次为71.43%,60.00%,84.62%,75.00%,28.57%,总准确度为67.50%。胃癌转移与非转移淋巴结的短径、长径相比,差异无统计学意义(P>0.05);转移淋巴结的强化程度为(48.39±5.77) HU,明显高于非转移淋巴结[(30.17±5.78) HU],差异有统计学意义(P<0.05)。结论:低剂量64排CT双期增强扫描对胃癌淋巴结转移的敏感度及特异度明显较高,可准确判断胃癌的病理分期,有助于提高诊断符合率,建议临床推广使用。
关键词: 胃癌;淋巴结转移;64排CT双期;敏感度;特异度;准确度

Value of low-dose 64-slice CT double-phase enhanced scan in the evaluation of lymph node metastasis of gastric cancer

Authors: 1LIU Wensi, 1LIN Chenglu, 1GUO Lei, 1WU Juhua
1 CT Room, Liu’an Second People’s Hospital, Liu’an Anhui 237000, China

CorrespondingAuthor: LIU Wensi Email: 4966906@qq.com

DOI: 10.3978/j.issn.2095-6959.2020.08.016

Abstract

Objective: To analyze the application value of low-dose 64-slice CT double-phase enhanced scan in the evaluation of lymph node metastasis of gastric cancer, and to provide reference for clinical diagnosis and treatment. Methods: Forty patients with gastric cancer admitted to Liu’an Second People’s Hospital from February 2015 to May 2019 were selected for study, all patients underwent low-dose 64-slice CT double-phase enhanced scan and conventional-dose CT three-phase enhanced scan, the surgical pathological results were compared with the results of CT examination. Results: The sensitivity and specificity of low-dose 64-slice CT double-phase enhanced CT in diagnosing lymph node metastasis of gastric cancer were 83.33% and 90.00% respectively, the difference was statistically significant (P<0.05); the sensitivity of the conventional three-phase enhanced CT scan to diagnose lymph node metastasis of gastric cancer is 62.50%, and the specificity is 43.75%,the difference was statistically significant (P<0.05); the accuracy of low-dose 64-slice CT dual-phase enhanced scan for pathological staging N0-N3b was 71.43%, 60.00%, 84.62%, 75.00%, and 28.57%, the total accuracy was 67.50%. The short and long diameter of gastric cancer metastasis and non-metastasis lymph nodes were compared, and the difference was not statistically significant (P>0.05). The enhancement of metastatic lymph nodes is (48.39±5.77) HU, which is significantly higher than that of non-metastatic lymph nodes [(30.17±5.78) HU], and the difference was statistically significant (P<0.05). Conclusion: The low-dose 64-slice CT double-phase enhanced scan has significantly higher sensitivity and specificity for gastric cancer lymph node metastasis, can accurately determine the pathological stage of gastric cancer, helps improve the diagnostic coincidence rate, which is recommended to promote clinical use.
Keywords: gastric cancer; lymph node metastasis; 64-slice CT double-phase; sensitivity; specificity; accuracy