Efficacy of helical CT in T-staging of gastric cancer
Efficacy of helical CT in T-staging of gastric cancer
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DOI：
10.1097/00004728-199701000-00014
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发表时间：
1997-01-01
影响因子：
1.3
通讯作者：
Masuda, K
中科院分区：
文献类型：
--
作者：
Fukuya, T;Honda, H;Masuda, K
目的：本研究的目的是评估螺旋CT在胃癌患者术前T分期中的表现。方法：对71例确诊为胃癌的患者[75个病灶，46个早期（T1）和29个晚期（T2或以上）癌症]进行螺旋CT评估。螺旋 CT 的切片厚度为 5 毫米，工作台增量为 5 毫米/秒。使用螺旋扫描的体积数据，获得轴向 CT 图像（5 毫米切片厚度，5 毫米间隔）和多平面重建 (MPR) 图像。将 CT 结果与切除标本的组织病理学研究进行比较。结果：螺旋 CT 对早期胃癌的敏感性为 26%（46 例中的 12 例），对晚期胃癌的敏感性为 100%（29 例中的 29 例）。螺旋CT误诊3个病灶为胃癌。组织病理学上，螺旋CT检测到的所有早期胃癌均为息肉样或隆起型，或表现为粘膜下层的大量侵犯。具有大量粘膜下浸润的 T1 癌与晚期癌症之间的区分很困难。 T2 和 T3 癌症之间的区分率为 73%（26 人中的 19 人），T1/T2 和 T3/T4（浆膜外浸润）之间的区分率为 83%（41 人中的 34 人）。总体 T 分期正确率为 66%（41 人中的 27 人）。与轴向 CT 图像相比，MPR 图像提高了检出率（三个病灶）或提高了 T 分期（八个病灶）的置信度。结论：当螺旋 CT 检测到非息肉状或隆起型且胃壁基本正常的胃癌时，它要么是癌细胞大量侵入粘膜下层的 T1 癌，要么是晚期癌症。然而，CT 上很难区分这两个阶段。螺旋CT并没有显着改善浆膜侵犯的诊断。 MPR 图像增加了对某些胃癌分期的信心，例如那些 CT 图像容易受到部分体积平均效应影响的位置的胃癌。
Purpose: The purpose of this study was to evaluate the performance of helical CT in preoperative T-staging in patients with gastric cancer.Method: A total of 71 patients with an established diagnosis of gastric cancer [75 lesions, 46 early (T1) and 29 advanced (T2 or more) cancers] were evaluated with helical CT. Helical CT was performed with 5-mm slice thickness at 5-mm/s table incrementation. Using the volumetric data by helical scanning, axial CT images (5-mm slice thickness at 5-mm intervals) and multiplanar reconstruction (MPR) images were obtained. CT findings were compared with histopathologic studies of the resected specimen.Results: Sensitivity of helical CT for gastric cancer was 26% (12 of 46) for early and 100% (29 of 29) for advanced cancer. Three lesions were misdiagnosed as gastric cancer by helical CT. Histopathologically, all early gastric cancers detected by helical CT were either polypoid or elevated types or showed massive invasion of the submucosal layer. The differentiation between T1 cancer with massive submucosal invasion and advanced cancer was difficult. The differentiation between T2 and T3 cancer was possible in 73% (19 of 26) and between T1/T2 and T3/T4 (extraserosal invasion) in 83% (34 of 41). Overall T-staging was correct in 66% (27 of 41). MPR images improved the detection rate (three lesions) or increased confidence in T-staging (eight lesions) over axial CT images.Conclusion: When helical CT detected gastric cancer that was not a polypoid or elevated type with underlying normal-appearing gastric wall, it was either T1 cancer with massive invasion of the cancer cells into the submucosal layer or advanced cancer. However, differentiation between these two stages was difficult on CT. Diagnosis of serosal invasion was not markedly improved by helical CT. MPR images increased confidence in the staging of certain gastric cancers, such as those in locations where CT images are susceptible to partial volume averaging effects.