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目的 观察和分析浸润型胃癌的CT表现特点 ,评价CT在浸润型胃癌诊断中的价值。资料与方法 32例浸润型胃癌患者接受了CT检查 ,经胃镜和 /或外科手术及病理证实。所有病例经动态增强或螺旋CT多期扫描检查。结果 32例CT检出病变 31例 ,2 9例得到正确诊断。根据CT主要表现 ,浸润型胃癌分为 4型 :胃壁局限性增厚型 4例 ;弥漫性增厚型 5例 ;局限性胃壁增厚合并胃腔缩窄型 10例 ;弥漫性胃壁增厚合并胃腔缩窄型 12例。强化方式为 :病灶在动脉期呈不均匀轻度强化 (8/ 2 3)或明显强化 (9/ 2 3) ;门脉期渐进性显著强化 (2 5 / 31) ;平衡期病灶延迟显著强化 (17/ 2 3)。其他表现 ,腹水 8例 ,网膜侵犯和腹腔种植 11例。结论 使用服水低张 ,螺旋CT多期或动态增强扫描技术 ,CT在弥漫浸润型胃癌诊断和鉴别诊断方面具有很高的准确性 ,有较高的临床应用价值。
Objective To observe and analyze the CT features of invasive gastric cancer and evaluate the value of CT in the diagnosis of invasive gastric cancer. Materials and Methods 32 cases of invasive gastric cancer patients underwent CT examination, endoscopy and / or surgical and pathological confirmed. All cases were dynamically enhanced or spiral CT multi-phase scan examination. Results 32 cases of CT detected lesions in 31 cases, 29 cases were correctly diagnosed. According to the CT’s main manifestations, invasive gastric cancer is divided into 4 types: gastric wall thickening in 4 cases; diffuse thickening in 5 cases; localized gastric wall thickening with gastric narrowing in 10 cases; diffuse gastric wall thickening combined Gastric constriction in 12 cases. The enhancement was as follows: the lesion was unevenly mild (8/2 3) or significantly enhanced (9/2 3) in the arterial phase; the progressive portal venous phase was significantly enhanced (25/31); the delay in the balance period was significantly enhanced (17/2 3). Other manifestations, ascites in 8 cases, retinal invasion and abdominal implantation in 11 cases. Conclusions The use of low water supply, spiral CT multi-phase or dynamic enhanced scanning technique, CT in diffuse infiltration of gastric cancer diagnosis and differential diagnosis with high accuracy, has a high clinical value.