CT三期增强扫描对胃癌淋巴结转移的诊断价值

目的:评价螺旋CT三期增强扫描对胃癌淋巴结转移的诊断价值,探讨转移淋巴结的CT三期增强扫描特征。方法:对73例进展期胃癌患者行CT平扫及三期动态增强扫描,并与手术病理结果对照。结果:转移淋巴结的主要CT征象:较小转移淋巴结以实性为主,随直径增大呈环状、囊状改变者增加;强化类型分为实性均匀强化,环带样强化和囊状不强化;强化峰值时间不同,以动脉期达强化峰值者多见。CT三期增强扫描诊断胃癌淋巴结转移的诊断符合率为86.3%,敏感度为86.2%,特异度为86.7%。CT三期增强扫描对转移淋巴结的检出率及诊断准确性高于CT平扫,二者间差异有显著性意义(P<0.05)。结论:CT三期增强扫描可进一步提高对胃癌淋巴结转移的诊断准确性,对术前全面评价淋巴结转移状况有重要临床价值。

Diagnostic Value of Tri-phasic Enhanced Spiral CT in the Diagnosis of Lymph Node Metastasis of Gastric Carcinoma

Objective:To investigate the diagnostic value of tri-phasic enhanced spiral CT in the diagnosis of lymph node metastasis in gastric carcinoma as well as its CT manifestations.Methods:Both plain and tri-phasic enhanced spiral CT scan of upper abdomen were performed in 73 patients with advanced gastric carcinoma,and the results were correlated with the surgical and pathologic findings.Results:The main features of lymph node metastases of gastric carcinoma with plain and tri-phasic enhanced spiral CT scan were:solid and homogeneous pattern,mainly in small lymph node;annular or cystic pattern in bigger nodes.The degree of lymph node enhancement was higher in arterial phase compared with that in venous and delay phases,For the tri-phasic enhanced spiral CT scan,the accuracy was 86.3%,sensitivity 86.2%,specificity 86.7%,respectively.The diagnosis accuracy and detectability of metastatic lymph node by tri-phasic enhanced spiral CT is better than that of plain scan,there was significant statistical difference between the two groups(P<0.05).Conclusion:The diagnostic accuracy of lymph node metastases in advanced gastric carcinoma can be improved by tri-phasic enhanced spiral CT.