多层螺旋CT术前初步评估胃癌分化类型的应用

Multislice spiral CT in evaluation of pathologic pattern of gastric cancer

目的探讨多层螺旋CT(MSCT)术前对胃癌病理分化类型进行初步评估的可行性。方法79例经胃镜诊断为胃癌并经手术证实的患者在术前进行MSCT平扫及双期增强(延迟时间为20s和70s)扫描。分析病灶生长方式、厚度及病变胃壁三期扫描CT值与病理分化类型间的关系。结果病变胃壁厚度及其生长方式均与病理分化类型相关。增强扫描时黏液癌强化较非黏液癌明显(P<0.01),而在非黏液癌中,低分化腺癌强化又较高分化腺癌明显(P<0.01)。结论利用MSCT可以在术前初步判断胃癌的病理分化类型。

Objective To discuss the utility of multislice CT （MSCT） in the evaluation of pathologic pattern of gastric cancer. Methods 79 patients with gastric cancer confirmed by endoscopy were performed with MSCT scan. CT scans were operated by using pre-contrast and contrast scanning which included arterial phase （20 s delayed） and portal venous phase （70 s delayed）. The CT value, growing pattern of lesions and thickness of gastric wall were studied and their relationship with pathologic findings were analyzed. Results Both thickness of gastric wall and growing patterns had close relationship to pathologic findings. In the portal phase after enhancement, mucinous carcinoma would have more powerful enhancement than non-mucinous carcinoma （P〈0.01）, and that of bad-differentiated carcinoma would be more powerful than well-differentiated carcinoma （P〈0.01）. Conclusion MSCT could estimate the pathologic patterns of gastric cancer before operation.