胃癌CT检查特征及临床价值

Features and clinical value of CT in gastric carcinoma

目的 探讨胃癌的CT影像学特征及其临床应用价值。方法 回顾性分析2014年8月~2015年10月期间经手术或胃镜病理确诊胃癌并于我院行腹部双源CT平扫及强化扫描的70例患者资料,并与手术或胃镜病理结果对照,分析CT在胃癌诊断、TNM分期中的临床应用价值。结果 70例胃癌患者肿瘤分布：胃窦部36例,胃底贲门部18例,胃体部14例,皮革胃2例;30例行手术治疗的胃癌患者术后病理分期：IV期20例,IIIB期2例,IIIA期2例,IB期4例,IA期2例。其中,CT对T分期的诊断准确率约76.67%（23/30）,N分期的诊断准确率约64.46%（78/121）。结论 结合多种后处理技术及增强扫描方法,CT对胃癌的诊断、术前评估及手术预后等方面具有重要的意义,是胃癌术前TNM分期的主要检查手段。

Objective To explore the CT characters and clinical value for gastric carcinoma. Methods We retrospectively analyzed of 70 cases with known gastric cancer confirmed by surgery or pathology who underwent CT examination in our institute from August 2014 to October 2015. We compared with surgery or pathology, analyzed the CT character, TNM staging in the diagnosis of gastric carcinoma. Results Among the 70 cases with known gastric cancer, 36 tumors were located at the gastric antrum, 10 tumors were located at the gastric fundus, 14 tumors were located at the gastric body, 2 cases preseuted with linitis plastica. Thirty patients were treated by surgery, 20 patients were diagnosed with staging IV, 2 patients with staging IIIB, 2 patients with staging IliA, 4 patients with staging IB, 2 patients with staging IA. The diagnostic accuracy of CT for T staging was 76.67% （23/30）, for N staging, the rate was 64.46% （78/121）. Conclusion Combined with imaging post-processing and enhancement technique, CT is a simple and useful examination to identify gastric carcinoma, and very useful for treatment planning. The diagnostic accuracy of CT was high for TNM staging of gastric cancer.