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目的探讨对比增强超声造影对胃下部癌区域淋巴结转移的预测价值。方法采用六氟化硫微气泡造影剂和连续实时成像对比脉冲序列技术,对250例经胃镜活检确诊的胃下部癌患者术前行超声造影及螺旋CT检查,诊断区域淋巴结转移情况,并与术后病理检查结果对比。结果对比增强超声造影预测胃下部癌区域淋巴结转移的准确率、敏感度、特异度、Youden指数分别为71 2%、70.3%、88.5%、0.588,螺旋CT预测结果分别为71.4%、66.4%、89.9%、0.563,两者预测区域淋巴结转移准确率的差异均无统计学意义(均P>0.05)。两者联合应用的预测准确率为82.5%。对比增强超声造影预测第3、8a、8p组淋巴结转移准确率明显高于螺旋CT;预测第1、11p组淋巴结转移准确率明显低于螺旋CT,差异均有统计学意义(P<0.05或0.01)。结论对比增强超声造影预测胃下部癌区域淋巴结转移具有一定的价值;对比增强超声造影联合螺旋CT检查可提高预测胃下部癌区域淋巴结转移的准确率.
Objective To investigate the predictive value of contrast enhanced contrast echocardiography in lymph node metastasis of gastric cancer. Methods Twenty-five patients undergone gastric cancer diagnosed by gastroscope biopsy underwent contrast-enhanced ultrasound and spiral CT before diagnosis of regional lymph node metastasis with SF6 microbubble contrast agent and continuous real-time imaging contrast pulse sequence technique. Post-pathological examination results contrast. Results The accuracy, sensitivity, specificity and Youden index of contrast enhanced contrast echocardiography were 71.2%, 70.3%, 88.5% and 0.588, respectively. The predictive value of spiral CT was 71.4% and 66.4% respectively. 89.9% and 0.563, respectively. There was no significant difference in the accuracy of predicting regional lymph node metastasis between the two groups (all P> 0.05). The combined prediction accuracy of the two is 82.5%. Contrast-enhanced contrast-enhanced ultrasound predicts the accuracy of lymph node metastasis in the 3rd, 8th and 8th groups is significantly higher than that of the spiral CT. The accuracy of predicting the lymph node metastasis of the 1st, 11th groups is significantly lower than that of spiral CT (P <0.05 or 0.01 ). Conclusions Contrast enhanced contrast echocardiography has some value in predicting regional lymph node metastasis of gastric cancer. Contrast enhanced contrast - enhanced ultrasound combined with spiral CT can improve the accuracy of predicting lymph node metastasis in lower gastric cancer.