【摘要】 目的：对进展期胃癌与胃良性病变在螺旋CT上胃活动度进行定量分析，并探讨其区别，以提高对进展期胃癌与胃良性病变的鉴别诊断水平。方法：回顾性分析经手术或活检病理确诊的52例进展期胃癌CT图像，研究病变部位在平扫及增强延迟期CT图像上位置的改变，得出横向、纵向移动和其总和值的大小，用以代表病变部位胃活动度，并与62例胃良性病变进行分析对比。结果：进展期胃癌组患者病变部位横向移动、纵向移动和总移动均值分别为1.23mm、1.13mm和2.37mm，均明显低于胃良性病变组（6.23mm、5.79mm、12.02mm）。Spearman相关分析显示，胃病变部位横向、纵向移动和总移动值与胃病变良恶性显著相关（P<0.01）,Mann-Whitney U检验显示各移动值在胃良、恶性病变间差异有统计学意义（P<0.01）。移动值越大，良性可能性越大，良恶性病变二者的移动值之间有一定的重合，良恶性病变的总移动值重合较少。总移动值>6mm患者均为良性，<6mm则均为恶性。结论：进展期胃癌破坏胃平滑肌，导致胃活动度降低，与良性病变有差异（P<0.01），尤其是总移动值，可以利用这一征象，辅助进展期胃癌的CT诊断，提高诊断准确性。更多还原

【Abstract】 Purpose: To quantitatively analyze the gastric mobility of advanced gastric cancer and benign gastric lesions on spiral CT, and to explore their difference, so as to improve the differential diagnosis of advanced gastric cancer and benign gastric lesions.Methods: The CT images of 52 patients with pathologically confirmed advanced gastric cancer were retrospectively analyzed. The changes of the position of the lesions on the unenhanced CT scan and enhanced CT delayed scan were observed, and the horizontal and vertical movement and the sum of their values were obtained. The gastric mobility of the lesion site was analyzed and compared with 62 cases of benign gastric lesions. Results: The average transversal movement, longitudinal movement and total movement of lesions in the advanced gastric cancer group were 1.23 mm, 1.13 mm and 2.37 mm, respectively, which were significantly lower than those in the gastric benign lesion group(6.23 mm, 5.79 mm, 12.02 mm). The Spearman’s rank correlation test result showed that the transversal, longitudinal and total movement values of gastric lesions were significantly correlated with benign and malignant gastric lesions(P<0.01), and the Mann-Whitney U test result showed that there were significant differences of transversal, longitudinal and total movement values between the benign and malignant gastric lesions(P<0.01). The greater the value, the greater the possibility of benignity. There was a certain overlap between the movement values of the benign and malignant lesions, and the total movement value of the benign and malignant lesions was less overlapped. Lesions with a total movement value greater than 6 mm were all benign, and those less than 6 mm were all malignant. Conclusion: Advanced gastric cancer destroys gastric smooth muscle,resulting in decreased gastric mobility, which is different from benign lesions(P<0.01), especially the total movement value. This sign can be used to assist the CT diagnosis of advanced gastric cancer and improve the diagnostic accuracy.更多还原