胃壁动态观察在胃癌CT诊断中的价值

Clinical value of dynamic observation of thc gastric wall in CT diagnosis of gastric cancer

目的 探讨胃壁动态改变在胃癌CT诊断中的临床应用价值。方法 对经手术病理证实 5 4例胃癌患者的CT资料进行回顾性分析 ,并与 2 0例正常者对照。通过CT平扫、增强及延迟多相位动态观察胃壁改变 ,以局限性胃壁厚度 >10mm作为胃壁增厚的诊断标准。结果 1.胃壁厚度的变化 :胃癌组胃壁厚度无变化 ,正常组胃壁厚度可变 ;2 .胃壁柔软度的变化 :胃癌组形态固定 ,正常组均有形态变化 ;3.胃壁增厚的形状改变 :胃癌组不规则增厚 ,表面密实平整 ;正常组可以清晰显示粘膜皱襞 ,部分胃壁中夹杂气泡影 ;4.胃壁强化的方式 :胃癌组病变部位明显不均匀强化 ,正常组粘膜皱襞强化呈线状。结论 局限性胃壁增厚存在于充盈不佳的正常胃体 ,运用多相动态观察胃壁的变化情况 。

Objective To evaluate the clinical value of dynamic observation of the gastric wall in CT diagnosis of gastric cancer. Methods CT manifestations of 54 documented patients of gastric cancer and 20 patients with other disease as control were analyzed retrospectively. Dynamic observation of the gastric wall were undergone by plan, contrasted and delayed CT scans. Localized thickness of gastric wall or more than 10 mm was regarded as thickening. Results A stable, irregular thickened and markdly in homogeneous enhanced gastric wall was seen in gastric cancer and a changeab1e regular gastric wall and linear enhanced mucosa were seen in normal one. Sometimes small air bladder occurred in normal wall. Conclusion There psesent localized gastric wall distention in poorly filled normal stomach. Dynamic observation of gastric wall by multi phase CT scans is very important in diagnosis of gastric cancer.