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目的 探讨胃癌的螺旋CT强化特征 ,评价口服水螺旋CT三期扫描对胃癌术前分期的诊断价值。方法 对 46例胃癌患者实施胃气钡双对比造影及口服水螺旋CT三期增强扫描 ,并与术后病理对照。结果 (1) 4 6例胃癌中 ,18例正常胃壁呈单层结构 ,2 8例正常胃壁在动脉期或门静脉期表现为 2～ 3层结构。 (2 ) 2例早期胃癌在动脉期及门静脉期明显强化 ,在平衡期强化程度明显下降。 44例进展期胃癌中 ,32例以门静脉期强化程度为著 ,与动脉期比较有显著性差异 (t =4 2 2 6 ,P <0 0 5 )。 (3)螺旋CT三期增强扫描对胃癌TNM分期的准确性为 81 0 %。结论 不同类型的胃癌具有不同的强化特征。螺旋CT三期增强扫描对胃癌术前分期的准确性明显高于普通CT。
Objective To investigate the characteristics of spiral CT enhancement in gastric cancer and evaluate the diagnostic value of oral water spiral CT in the preoperative staging of gastric cancer. Methods 46 patients with gastric cancer were performed double-contrast gastritis and oral water spiral CT three-phase enhanced scan, and compared with postoperative pathology. Results (1) In 46 cases of gastric cancer, 18 cases of normal gastric wall showed a monolayer structure, and 28 cases of normal gastric wall showed a 2 to 3 layer structure in the arterial phase or portal vein phase. (2) Two cases of early gastric cancer were significantly strengthened in the arterial phase and portal vein phase, and the degree of enhancement in the balance phase was significantly decreased. Of the 44 patients with advanced gastric cancer, 32 cases had enhancement of portal venous phase, and there was a significant difference compared with the arterial phase (t = 4 2 26, P <0 05). (3) The accuracy of triple-phase spiral CT in the diagnosis of gastric cancer TNM staging was 81.0%. Conclusion Different types of gastric cancer have different enhancement characteristics. The accuracy of three-phase spiral CT in preoperative staging of gastric cancer was significantly higher than that of ordinary CT.