多排螺旋CT术前诊断胃癌淋巴结转移的价值

Value of 64-slice spiral computed tomography in diagnosing lymph node metastasis of gastric cancer before operation

目的:探讨胃癌淋巴结转移的CT特征,指导临床合理制定治疗方案和进行预后分析。方法:对48例进展期胃癌患者术前行CT平扫及三期增强扫描,对检出的淋巴结分别从长径、短长径比值、密度及强化程度等4个方面判定淋巴结转移,并与手术病理结果进行对照。结果:淋巴结长径≥8 mm、短长径比值≥0.7、淋巴结平扫CT值≥25 Hu及淋巴结强化程度≥75 Hu作为CT诊断转移性淋巴结的标准,与病理结果对照一致性较好。结论:CT三期增强扫描从淋巴结长径、短长径比值、密度及强化程度等4个方面,对胃癌术前淋巴结有无转移可以作出初步判断,对临床选择合理术式及评估预后均有重要价值。

Objective：To explore the characteristics of spiral CT of lymph nodes metastases in gastric cancer,and provide the evidence for formulating clinical treatment schedule and analyzing the prognosis. Methods：Forty-eight patients with advanced gastric cancer before operation were detected by plain and tri-phasic enhanced spiral CT scan. The potential lymph node metastasis was evaluated by the long diameter, ratio of short to long diameter, density and enhanced degree of lymph nodes, which was compared with the postoperative pathological findings. Results：A long diameter more than or equal to 8 mm,ratio of short-to-long diameter more than or equal to 0. 7,CT value more than or equal to 25 HU and enhanced degree more than or equal to 75 Hu of lymph nodes could be as the CT diagnostic standard of lymph node metastasis,which was in consistency with the postoperative pathological findings. Conclusions：The long diameter,ratio of short to long diameter,density and enhanced degree of lymph nodes in tri-phasic enhanced spiral CT scan can diagnose the lymph node metastasis of gastric cancer before operation,which has important value in selecting surgical method and analyzing prognosis.