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目的回顾性分析胃常见恶性肿瘤的CT表现,探讨MSCT鉴别胃常见恶性肿瘤的意义。资料与方法经手术病理证实的49例恶性胃肿瘤患者术前常规行MSCT增强扫描。两位放射科医师采用盲法对CT图像进行分析,评价病灶浸润胃壁的程度,病变处胃壁厚度,病灶累及范围,周围淋巴结肿大以及病变强化程度。结果49例中,29例(59.1%)为腺癌,8例(16.3%)为淋巴瘤,12例(24.5%)为恶性间质瘤。腺癌主要表现为局限胃壁增厚或弥漫性浸润伴黏膜强化。淋巴瘤表现为局限于黏膜和黏膜下层的多区域侵犯,伴胃壁明显增厚和周围肿大淋巴结。恶性间质瘤的特征为突出于胃壁外的巨大肿块。结论根据胃壁受累程度及侵犯区域,MSCT有助于鉴别三种较常见的胃恶性肿瘤。
Objective To retrospectively analyze the CT findings of gastric common malignancies and to explore the significance of MSCT in differentiating common malignant tumors of the stomach. Materials and Methods Forty-nine patients with malignant gastric tumor confirmed by surgery and pathology were routinely scanned with MSCT. The two radiologists used blinded CT images to evaluate the degree of infiltration of the gastric wall, the thickness of the lesion, the extent of the lesion, the swollen lymph nodes and the degree of lesion enhancement. Results Of 49 cases, 29 (59.1%) were adenocarcinoma, 8 (16.3%) were lymphoma and 12 (24.5%) were malignant stromal tumors. Adenocarcinoma is mainly localized gastric wall thickening or diffuse infiltration with mucosal enhancement. Lymphoma is confined to the mucosal and submucosal multi-regional violations, with significant thickening of the stomach wall and surrounding enlarged lymph nodes. Malignant stromal tumors are characterized by huge lumps that protrude outside the stomach wall. Conclusion According to the degree of gastric wall involvement and the area of invasion, MSCT can help identify three of the more common gastric malignancies.