| Objective: To evaluate the clinical value of Multi-slice CT (MSCT) in the diagnosis and preoperative TNM staging of gastric carcinoma. Methods 1. In the same condition, 60 patients with gastric carcinoma conformed by histopathological examination and 20 normal adults were scanned by MSCT(Siemens Somatom Plus 4 Volume Zoom). The scan protocols included both non-enhanced and dynamic enhanced scanning. The scan exposal conditions were 125 kV and 150mAs.A slice collimation was 5mm for non-enhanced scanning, 2mm for dynamic enhanced scanning and 1.2mm for 3D or MPR. The scanning covered from diaphragm to the public bone.The arterial phase and parenchyma phase were obtained respectively 30s and 60s after the beginning of the injection of the nonion contrast agent 100ml (300mgI/ml). The thickness of stomach wall was measured and compared between normal persons and the patients with gastric carcinoma.MSCT findings of the gastric carcinoma were analyzed. 2. 50 patients with advanced gastric carcinoma were examined by MSCT, gastrointestinal series (GI), fiberoptic gastroscopy (FG) and transabdominal ultrasonography (US). The results were compared with postoperative pathological results .TNM staging ofthe lesion was made based on the site, size and extent of the lesion, local infiltration, adjacent enlarged lymph nodes and the distant visceral metastasis. 40 patients were diagnosed as advanced gastric carcinoma by both MSCT and transabdominal ultrasonography (US), having TNM staging was performed and compared with postoperative pathological TNM staging. Results In the 60 patients with advanced gastric carcinoma and 20 normal adults, MSCT could clearly display the shape and contourof the stomach.MSCT manifestations of gastric carcinoma included: thickened gastric wall (60cases), intragastric tumors (30cases), ulceration and circumference (6cases), the whole gastric luminal narrowing (4cases).The carcinomatous gastric wall was significantly thicker than that of the normal stomach, the normal stomach wall ranged from 1.63mm to 3.86mm. Thickness of the carcinomatous gastric wall ranged from 10.2mm to 36.4mm. In detection rate of MSCT, FG, GI and Transabdominal ultrasonography in the 50 gastric carcinoma patients was 98%, 100%, 88%, 80% respectively. The accuracy of MSCT is equivalent to FG in the detection of gastric carcinoma (P=0.315); superior to that of GI (P=0.027) and US (P=0.004). The accuracy of MSCT and US was 92.5% (37/40) and 72.5% (29/40) respectively in preoperative TNM staging of 40 patients with advanced gastric carcinoma.MSCT was superior to that of US. (X~2 = 5.541, P =0.019, P<0.05) . Conclusion: With the use of hypotonic agent ,orally-taking... |
