胃癌T分期多排CT增强扫描强化特点分析

Characteristics of MDCT enhancement scan in T staging of gastric cancer

目的:分析多排螺旋CT(MDCT)在胃癌T分期中CT增强扫描的强化特点。方法:37例胃癌患者术前MDCT平扫后双期增强扫描,并对胃及其周围组织进行重建分析,结合原始图片分析T分期强化特点,并与术后病理相对照。结果:静脉期的强化平均范围要大于动脉期,其中T1期病变表现为动静脉期均轻度强化,强化的范围相同。T2期以动脉期轻度强化,静脉期明显强化为主,且静脉期强化的范围更大。T3期动脉期轻度强化,静脉期明显强化较多,强化范围两者相同。T4期以动脉期显著强化,静脉期进一步强化为主。结论:对MDCT动态双期增强扫描胃壁强化方式的探讨有助于术前T分期,是一种值得推广的方法。

Objective： To analyze the characteristics of multi-detector spiral computed tomography （MDCT） enhancement scan in gastric cancer T staging. Methods： Thirty-seven gastric carcinoma patients were scanned by MDCT. After plain scans, patients were performed enhancement scans by arterial phase and portal venous phase. We reconstructed the stomach to three-dimension analysis, and combining the source images, we evaluate the scope and extent of the gastric carcinoma. Compared the CT scans with operations and pathological sections, to analyze the T staging characteristics. Results： The enhancement scopes in portal venous phase scan was much bigger than arterial phase scan in all patients. The slightly enhancement appeared both in portal venous phase and arterial phase scans and had the same enhancement scopes in T1 stage patients. In T2 stage, most patients enhanced in the way of slightly arterial phase and obviously portal venous phase enhancement, and enhancement scopes in portal venous phase scans was much bigger. In T3 stage, more than half of patients＇ enhancement way was same as T2 stage, but enhancement scopes in two phases scans was the same. In T4 stage, most patients were obviously enhanced in all phases. Conclusion： Combining the reconstruction technique, MDCT double-phrase scans can evaluate the scope and extent of the adenocarcinoma invasion, and be of some use in T staging of gastric carcinoma.