胃癌根治术后胃左动脉旁淋巴结的螺旋CT定位

目的测量并确定胃左动脉旁淋巴结在螺旋CT中的区域范围，指导胃癌根治术后放疗靶区的勾画。方法对36例胃癌病人手术时在胃左动脉根部放置钛夹。螺旋CT下取放疗体位行三期增强扫描、冠状位及矢状位重建，以T12椎体为参考点，测量胃左动脉旁淋巴结的三维方向，应用SPSS17．0统计学软件计算分析其分布，测算胃左动脉旁淋巴结根部所在位置的变异范围。结果Kolmogorov—Smirnov检验显示，全组在各边界近似服从正态分布，男、女胃左动脉旁淋巴结分布趋势是一致的。Pearson分析显示，胃左动脉旁淋巴结的边界与年龄、身高、体质量、椎体高、椎体宽无相关性（P〉o．05）。男、女胃左动脉旁淋巴结的前界分别为垂直于T12椎体最前缘切线（46．56±1．95）、（37．56±2．35）mm；后界分别为（17．50±2．02）、（16．44±2．34）mm；左界分别为距T12椎体左缘右（22．48±2．04）、（16．03±2．25）mm；右界分别为距T12椎体左缘左（14．33±2．12）、（5．53±2．35）mm；上界分别为距T12椎体上缘上（26．89±2．12）、（16．09±2．30）miil；下界分别为距T12椎体下缘下（9．58±2．13）、（8．58±2．36）mm。结论采用新的标记方法以及新的影像学技术可取得更准确的胃左动脉旁淋巴结的定位统计结果。

SPIRAL COMPUTED TOMOGRAPHY LOCALIZATION FOR LEFT GASTRIC ARTERY LYMPH NODE AFTER RADICAL OPER-ATION OF GASTRIC CANCER

Objective To measure and define the area of left gastric artery （LGA） lymph nodes, and to guide the target area for postoperative radiotherapy of gastric cancer. Methods Titanium clips were set around the roots of LGA in 36 patients at surgery. Under the spiral computer tomography （CT）, an enhancement scanning was done at radiotherapeutic position, the coro- nal and sagittal view were reconstituted. Taking T12 vertebral body as reference point, measurement of LGA lymph nodes in the three-d~rnens~onal direction was conducted. With SPSS 17.0 software, range of variation of localization of the root of LGA lymph nodes were obtained. Results According Kolmogorov-Srnirnov test, each border showed a normal distribution. The distribution tendency of lymph nodes surrounding LGA was consistent between male and female. Pearson analysis demonstrated that the border of lyrnph nodes around LGA was not correlated with the age, height, weight and size of vertebral body （P〉0.05）. The anterior boundary of the lymph nodes in male and female was perpendicular to the most leading edge of T12 vertebral body tangent, being （46.56±1.95）, and （37.56±2.35） mm, the posterior boundary was （17.50±2.02） and （16.44±2.34） mm, respectively; the distance of right boundary was （22.48±2.04） and （16.03±2. 25） mm from T12 vertebra left margin. The upper bound was （26.89±2.12） and （16.09±2. 30） mm from the superior margin of T12 body, and the lowerbound was （9. 58±2. 13） and （8.58±2.36） from the inferior border of T12. Conclusion By using a new labeling method and a new imaging technique, a more accurate positioning result for .lymph nodes surrounding left gastric artery can he obtained.