螺旋CT在胃癌胃周淋巴结转移诊断中的临床价值

The Clinic Value of Perigastric Metastatic Lymph Nodes Diagnosis in Gastric Carcinoma With Spiral Computed Tomography

目的探讨胃癌淋巴结转移的螺旋CT特征,指导临床合理制定治疗方案。方法回顾性分析经手术病理证实的29例胃癌胃周淋巴结转移的螺旋CT影像特征,并与术后病理进行对照研究。结果螺旋CT共检出增大淋巴结242个,其中阳性淋巴结有112个(阳性率46.3%)。以长径≥8 mm淋巴结阳性率达68.9%,以平扫CT值≥25 HU、增强动脉期CT值≥70 HU、增强静脉期CT值≥80 HU淋巴结的阳性率分别为71.7%、68.1%及70.5%。结论螺旋CT对判断胃癌胃周淋巴结转移有重要作用,采用淋巴结长径≥8 mm为诊断阳性淋巴结标准,结合淋巴结平扫CT值≥25 HU或增强动脉期CT值≥70 HU或增强静脉期CT值≥80 HU为诊断阳性淋巴结标准,大大提高对胃癌胃周淋巴结转移的诊断水平。

Objective To study the characteristics of spiral computed tomography（SCT） in the diagnosis of perigastric lymph nodes metastases in gastric carcinoma,to provide the evidence for clinicians to make appropriate treatment strategies. Methods The characteristics of SCT diagnosis of perigastric metastatic lymph nodes in 29 gastric carcinoma patients were retrospectively analyzed and compared with operation and pathology. Results A total amount of 242 swollen lymph nodes（112 positive）were detected by SCT and confirmed by pathology in metastasis-positive or metastasis-negative patients.The positive rate with diameter of lymph nodes≥8mm is 68.9%.If the attenuation values,≥25HU in plain scan or 70HU in arterial phase or 80HU in venous phase,were used as the threshold to detect the metastasis positive lymph nodes,the positive rate were 71.7%,68.1%,70.5% respectively.Conclusion SCT is valuable in judging the metastasis in gastric carcinoma.The reference of diameter≥8 mm.combining with the application of attenuation values more than or equal to 25Hu in plain scan or 70Hu in arterial phase or 80Hu in venous phase can dramatically improve the diagnosis for lymph nodes of perigastric metastasis in gastric carcinoma.