胃癌的多层面螺旋CT增强表现及局部侵犯范围的判断

Enhanced multi-slice CT findings and local invasion judgment of gastric carcinoma

目的:分析胃癌在多层螺旋CT增强早期的表现,评价多层螺旋CT增强早期对判断肿瘤局部侵犯范围的价值。材料与方法:29例胃癌病人术前1周内行螺旋CT平扫与增强扫描。CT所见与手术病理对照。结果:胃癌表现为局限(26例)或广泛(3例)的胃壁增厚,大多数胃癌在螺旋CT增强早期出现不同程度强化。印戒细胞癌CT强化均值为43.8 HU,低分化腺癌为36.2 HU,中分化腺癌为17.9 HU,高分化腺癌为19 HU。多层螺旋CT对胃癌浆膜侵犯、胃周脂肪间隙侵犯及脏器侵犯判断的准确率分别为89.6%、81.8%、93.1%。结论:多层螺旋CT增强早期胃癌的强化程度与其病理组织分化程度有相关性,对判断胃癌局部侵犯范围有一定实用价值。

Objective： To analyze early enhanced multi-slice CT （MSCT） manifestation of gastric carcinoma and to assess its value in the judgment of local invasion of gastric carcinoma. Methods： Twenty-nine patients with gastric carcinoma were given abdominal plain CT and contrasted MSCT within one week before surgery. CT findings were compared with surgical and pathologic findings. Results： The CT manifestation of gastric carcinoma included local （26 cases）, extensive （3 cases） thickening of gastric wall. In early phase of contrasted MSCT, different degree enhancement was observed in most gastric carcinoma. Average enhancement value was 43.8 HU, 36.2 HU, 17.9 HU and 19 HU respectively in signet ring carcinoma, poorly differentiated adenocarcinoma, moderately differentiated adenocarcinoma and well differentiated adenocarcinoma respectively. The accuracy of judging invasion of serosa, perigastric fat and adjacent organs were 89.6 %, 81.8 % and 93.1% respectively. Conclusion： The enhancement degree of gastric carcinoma appeares to be correlated with its histological grade. The early enhanced phase of MSCT is helpful in the identification of local invasion of gastric carcinoma.