Dynamic volume perfusion CT imaging for detecting and evaluating pathological type of early gastric cancer
Objective To observe the value of dynamic volume perfusion CT(DVPCT)imaging for detecting and evaluating pathological type of early gastric cancer.Methods Data of 127 patients with early gastric cancer confirmed by pathology were retrospectively analyzed.The patients were divided into enhanced CT group(n=67)and DVPCT group(n=60)according to preoperative examination methods.Clinical and CT data were compared between groups,and tumor enhancement,peak phase and peak time in both portal vein phase and venous phase were compared between patients with early gastric signet ring cell carcinoma(SRCC)and early gastric adenocarcinoma in DVPCT group.Then receiver operating characteristic(ROC)curves were drawn,the areas under the curves(AUC)were calculated to evaluate the efficacy of timedensity curve(TDC)of DVPCT images for differentiating early SRCC and early adenocarcinoma.Results The detection rate of tumor,dose-length product and effective dose in DVPCT group were all higher than those in enhanced CT group(all P＜0.05).No significant difference of patients'age,gender,pathological type,tumor location nor the maximum tumor size was found between groups(all P＞0.05).Among 52 patients(52/60,86.67％)with early gastric cancer detected with DVPCT,12 cases were found with SRCC,39 cases with adenocarcinomas and 1 case with mucinous adenocarcinoma.Significant difference of tumor enhancement,peak phase and peak time in both portal vein phase and venous phase were found between patients with SRCC or adenocarcinoma.Taken 37.3 s as the optimal cut-off value of peak time,the sensitivity,specificity,positive predictive value,negative predictive value,accuracy and AUC was 83.33％,84.62％,62.50％,94.29％,84.31％and 0.895,respectively.Conclusion DVPCT had better detecting ability for early gastric cancer than conventional enhanced CT,which could be used to effectively differentiating early gastric SRCC and early gastric adenocarcinoma according to TCD.
stomach neoplasmscarcinoma,signet ring celladenocarcinomatomography,X-ray computed
万方数据
维普
