进展期胃癌浸润程度及淋巴结转移的螺旋CT评价

EVALUATION OF GASTRIC WALL INFILTRATION AND LYMPH NODES METASTASES IN ADVANCED GASTRIC CARCINOMA WITH SPIRAL CT

目的评价螺旋CT（spiralcomputedtomography，SCT）术前判断进展期胃癌胃壁浸润程度及淋巴结侵犯情况的价值。方法回顾性分析36例经手术后病理证实的进展期胃癌患者（T2～T4期）的SCT双期扫描资料，每个病例的CT图像均对胃壁浸润深度及周围淋巴结侵犯情况进行评价，并将诊断结果与术后病理结果进行比较。结果36例胃癌中，胃底贲门癌15例、胃窦癌13例、胃体癌8例。CT对T4期胃癌胃壁浸润程度判断准确率较高，为73％（8／11例）；T2、T3的判断准确率相对较低，分别为33％和58％。对淋巴结转移的判断灵敏度较高，但假阴性率也高。结论SCT对进展期胃癌胃壁浸润深度和淋巴结转移的判断起着重要作用，然而诊断准确性仍待提高，有待相关研究的进一步深入。

Objective To study the value of spiral CT in evaluation the infiltration and lymph nodes metastases in advanced gastric carcinoma. Methods The double- phase CT images of 36 patients with gastric carcinoma were retrospectively analyzed, the gastric wall infiltration and lymph nodes metastases were evaluated by CT and compared with surgery and pathologic findings. Results Of all the 36 patients,15 were in the gastric fundus and cardia,13 in the sinus ventriculi and 8 in the gastric body. The accuracy in evaluating the gastric wall infiltration was about 73 %, while the accuracy in T2 and T3 were relatively low, 33% and 58% respectively. The sensitivity in detecting the lymph nodes metastases was high, though the false negative rate was high at the same time. Conclusion SCT is valuable in the evaluation of gastric wall infiltration and lymph nodes metastases in advanced gastric carcinoma. But more correlated studies should be taken to raise the accuracy rate.