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目的探讨能谱CT成像联合多向调整多平面重组(MPR)在术前评估胃癌T分期中的价值。方法搜集经术前病理确诊为胃癌并行腹部能谱CT扫描的患者65例,男49例,女16例,年龄22~84岁,中位年龄58.3岁;对常规混能及最佳单能量图像进行横轴位、冠状位、矢状位及多向调整MPR,后者以同层显示最大范围胃癌病变为佳;依据不同的重建图像进行T分期评估。结果术后病理证实T1期4例,T2期12例,T3期33例,T4期16例。常规混能轴位图像及最佳单能量轴位图像分别联合冠状位、矢状位、多向调整MPR对胃壁T分期的总的准确性分别为78.5%、81.5%、83.1%、87.7%;80.0%、84.6%、89.2%、92.3%;联合不同的重建方法在不同部位胃癌T分期诊断中的效能不同。结论能谱CT联合多种MPR进一步提高了胃癌T分期诊断的准确性。
Objective To investigate the value of spectral CT imaging combined with multiplanar adjustment multiplanar reconstruction (MPR) in the preoperative evaluation of T staging of gastric cancer. Methods Sixty-five patients (49 males and 16 females, aged 22-84 years, with a median age of 58.3 years) were enrolled in this study. The patients were diagnosed by gastric biopsy with preoperative pathology. Axis, coronal, sagittal and multi-directional adjustment MPR, the latter with the same layer showed the largest range of gastric cancer lesions were better; based on different reconstruction images for T staging. Results Postoperative pathology confirmed T1 in 4 cases, T2 in 12 cases, T3 in 33 cases and T4 in 16 cases. The total accuracy of multiphase MPR for the staging of gastric cancer with conventional mixed axial images and the best uniaxial axial images respectively was 78.5%, 81.5%, 83.1% and 87.7%, respectively. 80.0%, 84.6%, 89.2%, 92.3%. The different reconstruction methods in different parts of the T staging of gastric cancer different efficacy. Conclusion The combination of spectrum CT and multiple MPR can further improve the accuracy of T-staging for gastric cancer.