目的:探讨CT仿真内窥镜成像(CTVE)在早期胃癌中的诊断价值.方法:选取2016年6月至2017年7月河北省石家庄市第一医院收治的疑似早期胃癌患者110例,均接受CTVE、X线钡餐造影、电子内镜检查,并以手术病理诊断为金标准,评估3种检查方法的诊断价值.结果:经手术病理检查确诊为早期胃癌87例(79.09％),良性病变23例(20.91％);CTVE检出早期胃癌80例(72.73％),X线钡餐造影检出67例(60.91％),电子内镜检出69例(62.73％);CTVE诊断敏感度为88.51％,特异度为86.96％,准确率为88.18％,阳性预测值为96.25％,阴性预测值为66.67％,kappa值为0.679,与病理诊断一致性较好;CTVE诊断早期胃癌的曲线下面积为0.877(95％ CI:0.789～0.966),高于X线钡餐造影的0.830(95％ CI:0.742～0.918)与电子内镜诊断的0.842(95％ CI:0.755～0.928).结论:CTVE在早期胃癌诊断中具有较高应用价值,诊断特异度、敏感度、准确度均较高,且与病理诊断结果一致性较好,值得临床推广.%Objective:To evaluate the diagnostic value of CT virtual endoscopy (CTVE) in early gastric cancer.Methods:110 patients with suspected early gastric cancer were enrolled in this study.CTVE,X-ray barium meal and electronic endoscopy were performed.The results were compared with the pathological results.Results:87 cases (79.09 ％) of early gastric cancer and 23 cases (20.91％) of benign lesions were diagnosed by pathology.80 cases (72.73％) of early gastric cancer were detected by CTVE,67 cases (60.91％) were detected by X-ray barium meal,and 69 cases (62.73％) were detected by endoscopy.The sensitivity of CTVE was 88.51％,the specificity was 86.96％,the accuracy rate was 88.18％,the positive predictive value was 96.25％,the negative predictive value was 66.67％,and the kappa value was 0.679.The area under the ROC curve of CTVE in the diagnosis of early gastric cancer was 0.877,which was higher than that of X-ray barium meal (0.830) and electronic endoscopy (0.842).Conclusion:CTVE was valuable in the diagnosis of early gastric cancer.It had high diagnostic specificity,sensitivity and accuracy.
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