【摘要】 目的旨在探讨多层螺旋CT（MSCT）胃癌影像表现及在术前TNM分期中的诊断价值。方法选取我院2017年4月-2018年3月收治的胃癌患者56例,56例患者均进行MSCT检查,收集56例患者的手术资料、影像学资料,总结胃癌MSCT检查中图像特征,以手术后或病理学检查结果为参照,计算MSCT诊断胃癌T、N、M分期中的符合率。结果 MSCT对胃癌T分期的总诊断符合率为91.07%（51/56）,其中T₃期诊断符合率最高,为95.65%;MSCT对胃癌N分期的总诊断符合率为87.50%（49/56）,N₁期诊断符合率最高,为89.65%;MSCT对胃癌M分期的总诊断符合率为94.64%（53/56）,M₀期诊断符合率94.73%,M₁期诊断符合率94.44%;早期胃癌病变局限于黏膜层,呈现线形强化,浆膜面清晰;全胃癌胃壁呈现广泛性增厚,肝胃隐窝模糊,多数患者合并多淋巴结肿大;低分化胃窦癌MSCT平扫图像中提示胃窦壁明显增厚,脂肪间隙模糊,呈肿块样向腔内突出,MSCT增强扫描后,动脉期胃窦部病变呈明显,静脉期、延迟期呈持续强化。贲门癌局部胃壁明显增厚,脂肪间隙不清晰,贲门部周围出现多发结节影,强化模式:部分环形强化。结论 MSCT扫描评估胃癌手术前TNM分期准确性较高,能指导临床制定治疗方案。更多还原

【Abstract】 Objective To investigate the imaging features of multi-slice spiral CT（MSCT） gastric cancer and its diagnostic value in preoperative TNM staging. Methods 56 patients with gastric cancer admitted to our hospital from April 2017 to March 2018 were selected. All 56 patients underwent MSCT examination. The operative data and imaging data of 56 patients were collected. The image characteristics of MSCT examination of gastric cancer were summarized. The coincidence rate of MSCT in the diagnosis of T,N and M staging of gastric cancer was calculated with the results of surgery or pathology as the reference. Results The total diagnostic coincidence rate of MSCT for T staging of gastric cancer was 91.07%（51/56）, and the highest diagnostic coincidence rate was 95.65%（T₃）.The coincidence rate of MSCT in N stage of gastric cancer was 87.50%（49/56）, and that of N₁ stage was the highest（89.65%）. The coincidence rate of MSCT in M stage of gastric cancer was 94.64%（53/56）, that of M₀ stage was 94.73%, and that of M₁ stage was 94.44%. Early gastric cancer lesions were confined to the mucosa with linear enhancement and clear serosal surface. Gastric wall of total gastric cancer showed extensive thickening, liver and stomach recess was blurred, and most patients had multiple lymph node enlargement at the same time. MSCT plain scan images of poorly differentiated gastric antrum cancer showed that the wall of gastric antrum was obviously thicker, fat gap was blurred, and mass-like protruding into the lumen. After MSCT enhanced scan, the lesions of gastric antrum in arterial phase were obvious, and the lesions in venous phase and delayed phase were continuously enhanced. The local gastric wall of cardiac cancer was obviously thicker, the fat gap was not clear, multiple nodules around the cardia appeared. The enhancement mode was partial circular enhancement. Conclusion MSCT scanning is accurate in assessing TNM staging of gastric cancer before operation, and can guide clinical treatment.更多还原