摘要
目的探讨胃癌淋巴结转移的螺旋CT征象及其与病理学的关系。方法对59例进展期胃癌患者行螺旋CT平扫及三期动态增强扫描。结果①胃癌淋巴结螺旋CT呈融合型、强化明显、不均匀强化及直径≥9mm者,病理转移的阳性率较高(P<0.05);②胃癌组织呈低分化、BorrmannⅢ+Ⅳ、浸润深度T3～4、TNM分期Ⅲ+Ⅳ者,螺旋CT诊断淋巴结转移的阳性率较高(P<0.05),而与肿块的大小无关。结论胃癌淋巴结的螺旋CT征象(淋巴结分布类型、大小、强化程度、强化方式)可反映转移淋巴结的病理特性;胃癌组织的病理学特性(癌组织的分化程度、Borrmann分型、浸润深度及TNM分期)决定螺旋CT判定淋巴结转移的阳性率。综合胃癌组织及淋巴结的各种螺旋CT征象有助于提高CT诊断淋巴结转移的准确性。
Objective To discuss the spiral CT features of lymph node metastasis in advanced gastric cancer, and to inves tigate the correlation between spiral CT features and pathologic results. Methods Spiral CT scan and triphasic enhancement spiral CT scan were performed in 59 patients with advanced gastric cancer before operation. Results （1）The pathologic metastatic rate of lymph node in gastric cancer was high when the lymph nodes were nubby-mixed, prominently enhanced, unsymmetrical enhanced and ≥9 mm in diameter on spiral CT （P〈0.05）. （2）The detection rate of lymph node metastasis with spiral CT was high when carcinoma tissues were poorly differentiated, Borrmann Ⅲ ＋ Ⅳ , T3-4 staging and TNMⅢ ＋ Ⅳ staging. Conelusion The spiral CT features of lymph node （distributing type, size, enhanced degree, enhanced mode and staging） can reflect the pathologic characteristics of lymph node metastasis in gastric carcinoma. Pathologic characteristic of gastric tumor determines the detection rate of lymph node metastasis on spiral CT. The accuracy of CT to diagnose lymph nodes metastasis will be improved by integrating the spiral CT features of both gastric tumor and lymph node.
出处
《中国医学影像技术》
CSCD
北大核心
2009年第7期1211-1214,共4页
Chinese Journal of Medical Imaging Technology
基金
河南省自然科学基金(0611045100)
