胃癌肠转移的多层螺旋CT影像学特征

MSCT imaging features of intestinal metastases of gastric cancer

目的:探讨胃癌肠转移的多层螺旋CT影像学特征及发展规律.方法:将2011-08/2014-12来承德市中心医院治疗的胃癌肠转移患者96例,所有患者在X线初次发现肠转移的同期均进行了全腹CT平扫与增强检查,另有68例患者进行了二次CT复查.观察并分析胃癌肠转移患者的肠壁变化、腹膜腔变化等情况.结果:胃癌肠转移的肠壁变化主要表现在直肠和结肠肠壁的增厚及环形增强.经CT平扫,37.5%的胃癌肠转移患者有腹腔积液,且积液主要位于盆腔;二次CT平扫显示,在累及直肠或结肠的患者中,超过50%的患者病情加重.结论:胃癌肠转移可引起肠壁的增厚及强化.腹腔积液是胃癌肠转移的重要征象,且积液主要位于盆腔;X线气钡双对比灌肠表现轻微者CT图像上可能阴性,部分病例的CT改变可能要早于钡餐灌肠.

AIM： To investigate the MSCT imaging features of intestinal metastases of gastric cancer.METHODS： From August 2011 to December2014, 96 patients with intestinal metastasis of gastric cancer by X-ray underwent plain and contrast-enhanced abdominal CT scans at our hospital, and 68 of them underwent a second CT scan. The changes in intestinal wall and peritoneal cavity were observed.RESULTS： The changes in the bowel wall in patients with intestinal metastases of gastric cancer were mainly rectal and colonic wall thickening and annular enhancement. Plain CT scans showed that 37.5% of patients with intestinal metastases of gastric cancer had abdominal effusion, which was mainly located in the pelvic cavity. A second plain CT scan showed that more than 50% of patients became sicker in patients with involvement of the colon or rectum.CONCLUSION： Intestinal metastases of gastric cancer can cause bowel wall thickening and enhancement. Abdominal effusion, which is mainly located in the pelvic cavity, is an important sign of intestinal metastases of gastric cancer. X-ray double contrast barium enema may show negative results, which can be detected by CT earlier.