增强CT和~(18)F-FDG PET/CT在胃癌术前分期评估中的临床价值比较

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目的:对比评估增强计算机断层扫描(contrast enhancement computed tomography,CECT)和~(18)F-FDG正电子发射计算机断层扫描(positron emission tomography/computed tomography,PET/CT)在胃癌术前分期中的临床应用价值。方法:回顾性分析经病理证实的胃癌患者的术前CECT(27例)及~(18)F-FDG PET/CT(39例)图像,于两种影像学手段下,双盲法判定每位患者胃癌的TNM分期,然后分别计算每种影像学方法在胃癌术前分期中的敏感性、特异性、阳性预测值、阴性预测值和准确性。两种影像学方法的差异比较采用Pearson卡方检验。结果:CECT和~(18)F-FDG PET/CT诊断胃癌T分期的敏感性、阳性预测值和准确性分别是100.00%、72.73%、59.26%和100.00%、90.91%、76.92%;CECT和~(18)F-FDG PET/CT诊断胃癌N分期的敏感性、特异性、阳性预测值、阴性预测值和准确性分别是75.00%、71.43%、88.24%、50.00%、74.07%和42.86%、92.00%、75.00%、74.19%、35.90%。结论:CECT和~(18)F-FDG PET/CT均可用于胃癌术前分期的预估,尤其在N分期方面,CECT的敏感性和准确性高于~(18)F-FDG PET/CT。 OBJECTIVE: To compare the clinical value of enhanced enhancement computed tomography (CECT) and ~ (18) F-FDG positron emission tomography / computed tomography (PET / CT) in preoperative staging of gastric cancer Value. Methods: Preoperative CECT (27 cases) and ~ (18) F-FDG PET / CT (39 cases) images were retrospectively analyzed in patients with gastric cancer confirmed by pathology. The TNM staging of gastric cancer was calculated. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of each imaging method in preoperative staging of gastric cancer were calculated. The differences between the two imaging methods were compared using Pearson chi-square test. Results: The sensitivity, positive predictive value and accuracy of CECT and ~ (18) F-FDG PET / CT in diagnosing gastric cancer T stage were 100.00%, 72.73%, 59.26% and 100.00%, 90.91% and 76.92% The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ~ (18) F-FDG PET / CT in diagnosing gastric cancer staging were 75.00%, 71.43%, 88.24%, 50.00%, 74.07% and 42.86% , 92.00%, 75.00%, 74.19%, 35.90%. Conclusions: Both CECT and ~ (18) F-FDG PET / CT can be used to predict the preoperative staging of gastric cancer. The sensitivity and accuracy of CECT are higher than those of 18 F-FDG PET / CT .
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