MDCT联合多平面重建技术在胃癌术后复发诊断中的应用价值.doc

多层螺旋CT联合多平面重建技术在胃癌术后复发诊断中的价值 王勇 靳光华*2 付汉东3 （1湖北省黄石市中心医院普爱院区 湖北黄石 435001；2湖北省黄石市中心医院放疗中心 湖北黄石 435001；3湖北省孝感市中心医院 湖北孝感 432000） 摘要：目的：探讨多层螺旋CT(MDCT)联合多平面重建技术在胃癌术后复发诊断中的价值。方法：2011年2月到2015年1月对在我院进行胃癌根治术的患者120例进行调查，所有患者手术成功后在术后4个月都给予MDCT联合多平面重建技术进行诊断，并进行了临床资料的调查与分析。结果：CT诊断为术后复发40例，复发率为33.3%，其中局部复发25例，远处转移15例，常规CT扫描与腹部多平面重建图像都有很好的特征性。胃底、胃体和胃窦肿瘤的术后复发率分别为15.0%、12.5%和53.3%，胃窦肿瘤的术后复发率明显高于胃底与胃体(P0.05)。logistic多因素回归分析，结果显示肿瘤浸润深度与阳性淋巴结数是影响胃癌术后复发的独立危险因素(P0.05)。经病理和临床随访证实为复发42例，无复发78例，MDCT联合多平面重建技术在胃癌术后复发诊断中的应用敏感性与特异性为95.2%和100.0%。结论：肿瘤浸润深度与阳性淋巴结数是导致胃癌术后复发的危险因素，多层螺旋CT联合多平面重建技术在胃癌术后复发诊断中的应用对于局部复发与淋巴结转移的检出率都较高，具有很好的诊断敏感性与特异性。 关键词：多层螺旋CT；多平面重建技术；胃癌；复发 Multislice spiral CT with multiplanar reconstruction in the diagnosis of recurrent gastric cancer in value Wang Yong1 Jin Guanghua*2 Fu Handong3 （1.Huangshi Central Hospital of Hubei Province universal love hospital district, Huangshi, Hubei 435001, China;2.Hubei province Huangshi Central Hospital radiotherapy center, Huangshi, Hubei 435001, China;3.Xiaogan Central Hospital,?Xiaogan, Hubei 432000, China) Abstract: Objective: To investigate the diagnosis values of multi-slice spiral CT (MDCT) MPR for the gastric cancer postoperative recurrence. Methods: From February 2011 to January 2015 , 120 patients in our hospital were given to radical gastrectomy, all patients were given postoperative 4 months MPR MDCT diagnosis, and conducted survey and analysis of clinical data. Results: CT diagnosis of 40 patients of recurrence, the recurrence rate was 33.3%, of which 25 patients of local recurrence, distant metastases were 15 patients, conventional CT scanning and MPR images were all had good characteristic. The recurrence rate in the fundus, gastric body and antrum tumor were 15.0%, respectively, 12.5% ?and 53.3%, the recurrence rates compared were significantly difference(P 0.05). Multivariate logistic regression analysis showed that tumor infiltration depth and number of positive lymph nodes were the independent risk factors for gastric