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目的:探讨进展期胃癌在螺旋CT双期扫描中的强化特征。方法:60例进展期胃癌患者行螺旋CT双期增强扫描,分析肿瘤的强化特征,测定肿瘤区域的CT强化值,并与术后病理结果进行对比分析。结果:60例进展期胃癌患者中,12例(20%)肿瘤病灶呈单层强化,48例(80%)呈2～3层的分层强化。在分层强化的肿瘤病灶中,高分化腺癌组与低分化腺癌或未分化癌组病灶中层门脉期CT强化值差异有显著性意义(P<0.05)。黏液癌或印戒细胞癌病灶中层的CT强化值较低,有时出现“靶征”。肿瘤病灶中层门脉期的强化程度高于动脉期,差异有显著性意义(P<0.05)。结论:进展期胃癌有不同的强化特征,与病理学类型及分化程度有一定的关系。
Objective: To investigate the enhancement characteristics of advanced gastric cancer in spiral CT dual-phase scan. Methods: Sixty patients with advanced gastric cancer were scanned with double-phase helical CT. The enhanced features of the tumors were analyzed. The CT enhancement values of the tumor regions were determined and compared with postoperative pathological results. RESULTS: Of the 60 patients with advanced gastric cancer, 12 cases (20%) had monolayer lesions and 48 cases (80%) showed 2 to 3 layers of stratification. In stratified lesions, the CT enhancement values in the portal phase of the well-differentiated adenocarcinoma group and the poorly differentiated adenocarcinoma or undifferentiated cancer group were significantly different (P<0.05). The CT enhancement values in the middle layer of mucinous or signet-ring cell carcinoma lesions are low, sometimes with “target signs.” The intensity of enhancement of the middle portal vein phase of tumor lesions was higher than that of the arterial phase, with a significant difference (P<0.05). CONCLUSIONS: Advanced gastric cancer has different enhancement characteristics, and it has a certain relationship with pathological type and differentiation.