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目的探讨64排增强CT(MDCT)对进展期胃癌(AGC)手术根治程度的判断价值。方法分析70例AGC患者MDCT增强扫描的影像学资料,判断N2(第7、8和9组)淋巴结转移及脏器受侵情况,并将CT判断结果与手术后病理结果进行比较。结果62例患者接受手术治疗,8例因手术禁忌证无法行手术治疗。MDCT术前判定N2淋巴结转移的敏感性为92.0%(46/50),特异性为75.0%(9/12),准确性为88.7%(55/62)。MDCT术前判定存在N2或以上淋巴结转移者81.6%(40/49)行D2以上扩大根治术;判定N2淋巴结无转移者92.3%(12/13)行标准D2根治术。结论MDCT对诊断AGC N2淋巴结转移及周围脏器侵犯有重要价值,对AGC手术根治程度的判定有指导作用。
Objective To investigate the diagnostic value of 64-slice enhanced CT (MDCT) for the radical surgery of advanced gastric cancer (AGC). Methods The imaging data of MDCT enhanced scanning in 70 patients with AGC were analyzed to determine the lymph node metastasis and organ invasion in N2 (groups 7, 8 and 9). The CT findings were compared with the postoperative pathological findings. Results Sixty-two patients underwent surgery, and eight were unable to undergo surgery due to surgical contraindications. The sensitivity, specificity, and specificity of MDCT were 92.0% (46/50), 75.0% (9/12) and 88.7% (55/62) respectively. MDCT preoperative determination of N2 or more lymph node metastasis 81.6% (40/49) line D2 and more radical surgery; to determine the absence of N2 lymph node metastasis 92.3% (12/13) standard D2 radical mastectomy. Conclusion MDCT plays an important role in the diagnosis of lymph node metastasis of AGC N2 and invasion of surrounding organs, and plays a guiding role in determining the degree of radical gastrectomy.