螺旋CT不同体位扫描技术在进展期胃癌诊断中的应用

Diagnostic value of different scanning projection on spiral CT for advanced gastric carcinoma

关键词:  不同体位  螺旋CT  X线计算机  进展期胃肿瘤  诊断

Key words:  different projection  spiral CT  X computer  advancing gastric carcinoma  diagnosis

摘要:

目的采用螺旋CT的不同体位扫描技术在进展期胃癌诊断中的应用。方法回顾分析48例经病理证实的进展期胃癌不同体位螺旋CT扫描的影像资料,全部病例首先选用常规仰卧位扫描,发现病变36例,对可疑病变的12例,辅助左前斜位（6例）、左侧卧位（4例）、俯卧位（2例）扫描,均能清晰显示病变,所有病例均行增强扫描。结果仰卧位扫描检出胃窦部胃癌21例,漏诊6例;胃底贲门癌9例,漏诊4例,胃体部胃癌6例,漏诊2例,所有漏诊病例均发生在前壁,仅选用仰卧位CT扫描,阳性率为75%,漏诊率为25%,辅助左前斜位、左侧卧位、俯卧位扫描均能发现肿瘤,检出率为100%。结论不同体位CT检查很好地弥补了常规仰卧位检查的不足,有效地提高诊断准确率。

Abstract:

Objective To evaluate the diagnostic value of different scanning projections on spiral CT for advanced gastric carcinoma.Methods The clinical data and spiral CT scan results of 48 patients with advanced gastric carcinoma were retrospective analyzed.All the cases underwent CT examination on the conventional scanning supine projection,and gastric lesions were detected in 36 cases.In 12 suspicious cases,the left anterior oblique（LAO）,left lateral position（LLS） and prone projection were supplemented in 6,4 and 2cases respectively.All scans were performed with contrast media enhancement.Results On supine projection,gastric carcinoma at antrum was diagnosed in 21 cases and missed in 6 cases;carcinoma at fundus was diagnosed in 9 cases and missed in 4 cases;carcinoma at body was diagnosed in 6 cases and missed in 2 cases.The positive diagnostic rate on supine projection was 75.0%（36/48）,all the missing lesions were located in the front wall.If the LAO,LLS and prone projection were added the accurate rate of diagnosis rose to 100.0%.Conclusion The conventional supine projection on spiral CT supplemented with different scanning projections would effectively improve the accuracy in diagnosis of advanced gastric cancer.