数字胃肠造影与螺旋CT在胃癌诊断中的价值

Evaluation of the digital gastrointestinal and spiral CT in diagnosis of gastric carcinoma

目的研究数字胃肠造影和螺旋CT在胃癌诊断中的应用价值。方法收集具有完整胃部检查病例48例,其中造影检查48例,CT检查40例,所得结果均经临床手术和胃镜病理证实,并对两种检查结果和影像学特点进行对比分析。结果胃肠造影诊断胃癌48例,诊断准确率为92%(44/48),CT诊断胃癌36例,诊断准确率为90%(36/40)。胃癌的造影特征:以不规则龛影为主29例,以充盈缺损为主20例,沿黏膜面浸润并结节样隆起9例,胃小区模糊、破坏17例,胃腔狭窄8例,蠕动异常22例,幽门不全梗阻4例。CT检查特征为:胃壁不规则增厚31例,胃腔内、外不规则肿块9例,黏膜表面凹凸不平7例,胃腔狭窄5例,胃周、胰头周围淋巴结及远处脏器转移20例。结论在胃癌诊断中,数字胃肠造影和螺旋CT各具优势,应相互补充,若两者联合应用可扩大胃癌诊断范围,为临床术前分期、选择和制定合理的治疗方案提供有价值的依据。

Objective To evaluate the application of the digital gastrointestinal and spiral CT in the diagnosis of gastric carcinoma.Methods Forty-eight cases,including 48 cases of gastrointestinal contrast and 40 cases of CT, with complete gastric examination were collected.All the results were confirmed by surgeries and pathologies.The comparative analysis of the results and imaging features of the two methods were done.Results Forty-eight cases of gastric cancer were diagnosed with gastrointestinal contrast,with accuracy rate of diagnosis for 92%（44/48）.Tirty-six cases of gastric cancer were diagnosed with CT,with accuracy rate of diagnosis for 90%（36/40）.The imaging features of gastric cancer under gastrointestinal contrast were： irregular niche in 29 cases,filling defect in 20 cases,extension through gastric mucosa with nodular bump in 9 cases,shadowy and destruction image in gastric area in 17 cases,gastral cavity stenosis in 8 cases,abnormal gastric peristalsis in 22 cases,incomplete pyloric obstruction in 4 cases.The imaging features of gastric cancer with CT were： abnormal thickening in the stomach wall in 31 cases,irregular nods in or outside of the gastral cavity in 9 cases,uneven mucosal surface in 7 cases,gastral cavity stenosis in 5 cases, metastasis to the lymph nodes around stomach or the head of pancreas and distal metastasis in 20 cases.Conclusion In the diagnosis of gastric carcinoma,either digital GI or spiral CT has its own advantage and should be complemented each other.We need combine the digital GI and spiral CT,then it will expand the scope of the gastric cancer diagnosis,and provide valuble evidence in preoperative staging,choosing and establishing treatment plans.