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目的 探讨进展期胃癌螺旋CT三期扫描的影像学表现及其对胃壁浸润深度的评估价值。材料与方法 31例病理证实的进展期胃癌 ,分别于注射对比剂后 2 5～ 30s(动脉期 )、70～ 80s(非平衡期 )及 180～ 12 0s(平衡期 )行螺旋CT扫描 ,其后行多平面重建。结果 进展期胃癌检出率 10 0 %。 80 .6 % ( 2 5 /31)的病灶与胃壁分界截然 ,19.4% ( 6 /31)的病灶与周围胃壁呈移行状态。病灶强化情况在不同时相有所不同。动脉期 :11例肿瘤突向胃腔内的表面部分呈线样强化 ,其余部分未见明显强化 ,病灶分为 2层 ;16例肿瘤呈不规则团块状强化 ;4例病灶轻度均匀强化。 6 7.74% ( 2 1/31)的病例此期显示最清楚。非平衡期 :2 0例病灶呈不均匀强化 ;6例病灶分层 ,内层强化最明显 ,中间出现一条不甚连续的低密度带 ,外层呈团块状强化 ;5例病灶均匀强化。 12 .90 % ( 4 /31)的病例此期显示最清楚。平衡期 :2 7例病灶均匀强化 ,但强化程度较非平衡期时降低 ;4例病灶强化程度下降 ,但仍分层。 6 .45 % ( 2 /31)的病例此期显示最清楚。 12 .90 % ( 4 /31)的病例在上述三期中均很清楚。 19例手术者 ,T分期准确率达 78.94% ( 15 /19) ,其中T2与T3 之间鉴别的准确性为 81.2 5 % ( 13/16 )。经多平面重建 ,3例避免了T分期错误。结论 ?
Objective To investigate the imaging features of spiral CT three-phase scanning in advanced gastric cancer and its evaluation value of depth of gastric wall invasion. Materials and Methods Thirty-one cases of pathologically proven advanced gastric cancer were examined by spiral CT at 25 ~ 30s (arterial phase), 70 ~ 80s (non-equilibrium phase) and 180 ~ 120s (equilibrium phase) after contrast injection. Posterior multiplanar reconstruction. Results The detection rate of advanced gastric cancer was 10%. Eighty-six percent (25/31) of the lesions were distinct from the gastric wall, and 19.4% (6/31) of the lesions showed a transitional state with the surrounding stomach wall. Lesion enhancement is different at different times. Arterial phase: Intensity enhancement was observed in the surface of the 11 tumors protruding from the stomach cavity. No enhancement was observed in the rest of the tumors. The lesions were divided into 2 layers; 16 tumors showed irregular mass-like enhancement; 4 lesions were mildly evenly strengthened. . 6 7.74% (2 1/31) of the cases showed the most clearly in this period. In the non-equilibrium period, lesions were heterogeneously enhanced in 20 cases, stratified in 6 cases, and the inner layer was most markedly enhanced. In the middle, there was a non-continuous low-density zone. The outer layer showed mass-like enhancement; 5 lesions were evenly strengthened. 12. 90% (4/31) of the cases showed the most clearly in this period. Balance period: The lesions were evenly enhanced in 27 cases, but the degree of enhancement was lower than that in the non-equilibrium period. In 4 cases, the intensity of the lesions decreased, but it was still stratified. The 6.45% (2/31) case showed the most clearly in this period. 12.9% (4/31) of the cases were clear in the above three phases. In 19 patients, the accuracy rate of T stage was 78.94% (15/19), and the accuracy of discrimination between T2 and T3 was 81.25% (13/16). After multiplanar reconstruction, T-stage errors were avoided in 3 cases. in conclusion ?