浸润型胃癌的CT表现特点与临床应用价值

目的 观察和分析浸润型胃癌的CT表现特点，评价CT在浸润型胃癌诊断中的价值。资料与方法 32例浸润型胃癌患者接受了CT检查，经胃镜和/或外科手术及病理证实，所有病例经动态增强或螺旋CT多期扫描检查。结果 32例CT检出病变31例，29例得到正确诊断。根据CT主要表现，浸润型胃癌分为4型；胃壁局限性增厚型4例；弥漫性增厚型5例；局限性胃壁增厚合并胃腔缩窄型10例；弥漫性胃壁增厚合并胃腔缩窄型12例，强化方式为；病灶在动脉期呈不均匀轻度强化（8/23）；门脉期渐进性显著强化（25/31）；平衡期病灶延迟显著强化（17/23）。其他表现，腹水8例，网膜侵犯和腹腔种植11例。结论 使用服水低张，螺旋CT多期或动态增强扫描技术，CT在弥漫浸润型胃癌诊断和鉴别诊断方面具有很高的准确性，有较高的临床应用价值。

CT Features of Infiltrative Gastric Carcinoma

Objective To study CT features of infiltrative gastric carcinoma, and to evaluate CT scanning in the diagnosis of the disease. Materials and Methods CT scanning was performed in 32 patients with pathologically proved infiltrative gastric carcinoma. Water was used as oral contrast. CT findings were retrospectively analyzed.Results Of 32 cases, the lesion was detected on CT in 31, and correct diagnosis was made in 29. Based on CT signs, infiltrative gastric carcinoma could be divided into 4 types. (1) Localized thickening of the gastric wall (n=5). (2) Diffuse thickening of the gastric wall (n=5). (3) Localized thickened gastric wall accompanied with gastric coarctation (n=10). (4) Diffusely thickened gastric wall accompanied with gastric coarctation (n=12). Besides, ascites was seen in 8 patients and mesenteric involvement with abdominal implantation metastasis in 11 patients.Conclusion With oral administration of water and hypotonic agent, multi phase or dynamic enhanced helical CT scanning is very useful in diagnosing and differentiating infiltrative gastric carcinoma.