目的:研究多层螺旋CT多平面图像重组技术(multiplanar reformation,MPR)对肺部病变定位诊断的价值。方法:398例患者行胸部多层螺旋CT薄层扫描后,采用MPR技术将横断面图像重组,分别获得矢状和冠状位的MPR图像。三位高年资医师分别在横断和矢冠状重组图像上确定病变部位,两位或两位以上均诊断为同一位置者确定为病变部位,纳入统计分析。所有资料用χ2检验。结果:398例中,矢冠状重组图像组无定位诊断错误,横断图像组有22例定位诊断错误。两者间差异无统计学意义(Pgt;005)。结论:多层螺旋CT MPR图像定位准确性较高,对少数横断图像难以定位的病变可加作MPR重组图像。
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.