胃癌结直肠转移瘤的MSCT诊断

The clinical and MSCT diagnosis of colorectal metastases from gastric carcinoma

目的分析胃癌结直肠转移瘤的MSCT表现。方法分析52例胃癌结直肠转移患者的临床与CT资料。结果1)胃癌病理类型为低分化腺癌或印戒细胞癌及两者混合者45例;Ⅲ型及Ⅳ型48例;2)转移瘤表现为均匀增厚型39处,非均匀增厚型21处,管腔内生肿块型6处,管腔外突肿块型4处;3)转移瘤表现为均匀性强化16处;不均匀性强化10处;分层样强化44处;4)12例(52.2%)女性患者伴卵巢转移。结论发生结直肠转移的胃癌病理类型主要为低分化腺癌及印戒细胞癌,Borrmann分型以Ⅲ、Ⅳ型为主。结直肠转移瘤最具特征性的CT征象为肠壁呈靶样同心圆样改变。女性患者常伴卵巢转移。

Objective To analyze the MSCT manifestations of colorectal metastasis of gastric carcinoma,to summarize the imaging characteristics,clinical and pathological characteristics and to improve the understanding of colorectal metastasis of gastric carcinoma. Methods We collected the CT and clinical data of 52 patients with colorectalmetastases from gastric carcinoma. Results 1） The pathological types of gastric adenocarcinoma are mainly low differentiated adenocarcinoma and signet ring cell carcinoma or a mixture of both in 45 patients; III and type IV type in 48 patients; 2） Colorectal metastases show uniform thickening of39 lesions,non-uniform thickening of 21 lesions,intraluminal masses of 6 lesions,extraluminal massesof 4 lesions; 3） Colorectal metastases show homogeneous enhancement of 16 lesions; heterogeneousenhancementof 10 lesions; stratified enhancementas target of 44 lesions; 4） 12 female patients（ 52. 2%） are with ovarian metastasis. Conclusion The pathological types of patients with colorectal metastasis from gastric carcinoma are mainly low differentiated adenocarcinoma and signet ring cell carcinoma,the Borrmann type are III type and IV type. The CT features of colorectal metastases are concentric circular thickening of the intestinal wall as target,and a progressive thickening of the inner enhancing layer. Female patients are often with ovarian metastasis.