目的:研究多層螺旋CT多平面圖像重組技術(multiplanar reformation,MPR)對肺部病變定位診斷的價值。方法:398例患者行胸部多層螺旋CT薄層掃描后,采用MPR技術將橫斷面圖像重組,分別獲得矢狀和冠狀位的MPR圖像。三位高年資醫師分別在橫斷和矢冠狀重組圖像上確定病變部位,兩位或兩位以上均診斷為同一位置者確定為病變部位,納入統計分析。所有資料用χ2檢驗。結果:398例中,矢冠狀重組圖像組無定位診斷錯誤,橫斷圖像組有22例定位診斷錯誤。兩者間差異無統計學意義(Pgt;005)。結論:多層螺旋CT MPR圖像定位準確性較高,對少數橫斷圖像難以定位的病變可加作MPR重組圖像。
Objective To explore the value of multidetector row helical CT （MDCT） in the diagnosis of lymph node metastasis in adenocarcinoma of esophaogastric junction （AEG）， and to study the pattern of lymph node metastasis of it. Methods The MDCT images of 60 patients with AEG who underwent operation in our hospital from Jan. 2011to Oct. 2012 were collected， in order to explore the value of MDCT in the diagnosis of lymph node metastasis in AEG， and to study the pattern of lymph node metastasis of it. Results With diameter upper 8 mm and the difference of the mean value of enhanced degree upper 70 Hu as the standard of lymph node metastasis， the Kappa value （0.819 and 0.718），sensitivity （83.1% and 91.8%）， and specificity （78.9% and 83.5%） were all optimal. The lymph node metastasis rate was significantly higher in serosa invasion group than those of non-invasion group （P＜0.05）. The metastatic area of lymphnodes mainly concentrated around cardia （No. 7， 8， and 9 group）， lesser curvature of the stomach， celiac axis， and hepato-gastric ligament （No. 10， 11， 12， and 14 group） with the metastasis rate of 83.8% and 82.3%， respectively. Conclusion MDCT is useful to confirm the features， location， and rules of lymph node metastasis in patients with AEG， which is helpful in accurately cleaning the lymph nodes.