残胃癌的多层螺旋CT表现与术后病理对照分析

目的：探讨残胃癌的多层螺旋CT表现以及多层螺旋CT对残胃癌的诊断价值。方法收集经手术病理证实的22例残胃癌的螺旋CT检查结果，分析不同病理类型的残胃癌的螺旋CT表现。结果22例残胃癌均经手术病理证实，其中印戒细胞癌5例，低分化腺癌7例，中分化腺癌7例，高分化腺癌3例。残胃癌的病理类型以低分化腺癌多见，好发于吻合口，CT表现为吻合口及残胃胃壁受侵犯最常见，其次为贲门区胃壁，再次为食管下段及空肠，表现为胃壁增厚，僵硬，形态不规则，不均匀强化。结论多层螺旋CT对残胃癌的定位和定性诊断提供一定依据，CT表现可与病理类型相对应并对外科手术方式及其他临床治疗方案的选择具有一定参考价值。

Multislice spiral CT findings of gastric stump cancer with pathologic correlation

Objective To analyze the multislice CT (MSCT) findings and elucidate the CT diagnostic value for gas-tric stump cancer (GSC). Method MSCT images of 22 cases with GSC proved by surgery and pathology were reviewed. The tumor location, margin and signal intensity were analyzed. Result CT images of 22 cases included 5 cases of signet-ring cell carcinoma, 7 cases of poorly differentiated adenocarcinoma, 7 cases of moderately differentiated adenocarcino-ma, and 3 cases of highly differentiated adenocarcinoma. The tumors commonly developed at the site of the gastro-jejunal anastomosis as poorly differentiated carcinoma, followed by cardiac gastric wall, and lower part of esophagus and jeju-num. GSC showed thickened, stiff gastric wall on MSCT, which was irregular, with uneven reinforcement. Conclusion MSCT is helpful in localizing and qualitatively diagnosing the residual stomach cancer, besides, the CT manifestations correspond to pathologic type, and is valuable in determining the surgical operation method and other clinical treatment choice.