目的 分析128层螺旋CT增强扫 描对胃癌术前TNM分期的临床诊断价值。 方法 选取2012年1月至2014年9月作者所 在医院收治的44例胃癌患者，上述患者 均接受了128层螺旋CT增强扫描，根据扫 描结果对患者进行TNM分期诊断，并与病 理TNM分期诊断结果进行对比，判断128 层螺旋CT增强扫描对胃癌术前TNM分期 的临床诊断价值。结果 T1期准确率为 50.00%，T2期准确率为63.64%，T3期准 确率为73.68%，T4期准确率为90.00%，T 期整体准确率为72.73%；N0期准确率为 68.75%，N1期准确率为76.19%，N2期准确 率为85.71%，N期整体准确率为75.00%； M0期准确率为96.67%，M1期的准确率为 85.71%，M期整体准确率为93.18%；CT与 病理诊断对比在T分期与N分期上有显著性 差异(P＜0.05)，而在M分期对比上无显著 性差异(P＞0.05)。结论 128层螺旋CT可 较准确地显示胃癌侵犯胃壁的深度、淋巴 结转移和远处脏器的转移情况，在胃癌M 分期判断上有较高的准确率，值得临床推 广。

Objective To evaluate the clinical value of enhanced 128-slice spiral CT in the diagnosis of TNM staging of gastric cancer. Methods 44 patients with gastric cancer underwent 128-slice spiral CT scan from January 2012 to September 2014. The patients were diagnosed by TNM staging according to the scan results and staged with pathological TNM stage and to evaluate the clinical value of 128-slice spiral CT in the preoperative TNM staging of gastric cancer. Results The accuracy of T1 was 50.00%, the accuracy of T2 was 63.64%, the accuracy of T3 was 73.68%; the accuracy of T4 was 90.00%, the overall accuracy of T was 72.73%, the accuracy of N0 was 68.75%, the accuracy rate of N1 was 76.19%, the accuracy of N2 was 85.71% and the accuracy of N was 75.00%. The accuracy rate of M0 was 96.67%, the accuracy of M1 was 85.71% and the accuracy of M was 93.18%. There was significant difference between CT and pathological diagnosis in T stage and N stage (P<0.05), but there was no significant difference in M stage (P>0.05). Conclusion 128-slice spiral CT can accurately show the depth of stomach invasion, lymph node metastasis and metastasis of distant organs in gastric cancer. It has high accuracy in judging M staging of gastric cancer and worthy of popularization.