| According to the International Council for Research on Cancer (IARC) report on the world die each year from malignant tumors of the patients accounted for 35.0% of digestive system tumors. In China, a total mortality of gastric cancer mortality rate of 23.02% of malignant, ranking first in the death of various types of cancer. Endoscopy and double-contrast radiography is the main diagnosis of gastric cancer detection tool, but can only reflect the situation of the surface of the stomach cavity. Prognosis of gastric cancer and gastric cancer invasion depth and lymph node involvement is significantly related to each other. Gastric cancer invasion and the correct assessment of the scope of surgery and treatment of clinical significance. Therefore, the tumor staging of gastric cancer treatment and prognosis is particularly important. At present, the depth of invasion of gastric cancer detection and preoperative staging is the primary means of CT, MR, endoscopic ultrasound (EUS) and so on. Ultrasound lower resolution than CT, indicating a rather small scope, the overall anatomy of the stomach show that less than ideal, and for patients who rely on the extent of the operation of larger, they can have greater preoperative staging limitations. Endoscopic ultrasound of gastric wall invasion depth and lymph node detection of gastric weeks have considerable sensitivity, but weeks away from the stomach lymph nodes, liver and peritoneal metastasis detection limits have on the overall anatomy of the show and not CT; and does not check on the patients.Objective: To investigate the 64-slice spiral CT scanning and 3 to enhance the use of water as contrast agent in the preoperative evaluation of gastric cancer in value. Data and Methods: A collection of our hospital in October 2007 - 2008 10 months by surgery and pathology confirmed 50 cases of gastric cancer patients, including 36 cases of male, female 14 cases, aged 35-71 years old, average 58 years old, are in pre-operative week-long exercise of three 64-slice spiral CT enhanced inspection. 6 h before the inspection ban diet, intramuscular injection 10 min before the inspection Anisodamine 20 mg to reduce gastric peristalsis, cramps and discomfort in patients. Oral temperature of water 600-800 ml. GE companies to adopt 64-slice spiral CT scan. Scanning parameters of 120 kV ,200-300 mA, spiral 64-slice collimation×0.625 mm, reconstruction slice thickness 1.25mm, into the bed speed of 13.75 mm / rot, scanning from top to umbilical diaphragm, in accordance with appropriate increases to the pelvic scan . After the first CT scan. Enhanced scanning using non-ionic contrast agent Ultravist (300 mgI / ml) 100 ml, by the elbow through the high-pressure syringe rapid intravenous injection of contrast medium, injection flow rate of 3 ml / s. , Respectively, after contrast injection in the 25s, 60s and 3 min to start the arterial phase, portal venous phase and the balance period of three scans. And in accordance with lesions in different parts of the body increases to other supplementary scan, and gastric cardia lesions taken at the bottom or the left supine position, gastric body in supine position taken by the disease, and then check the right side of the antrum or supine left anterior oblique. GE spread to all the scan data of three-dimensional image workstations, workstation use ADW4. 3 software MPR based on the need for reconstruction. Analysis of multi-slice spiral CT findings with the pathological results after the operation.Results: In this study, 50 cases of gastric cancer patients with pathological results of T staging: T1 period of nine cases, T2 period of 13 cases, T3 period of 12 cases, T4 period of 16 cases. MSCT of the T phases: T1 period of 8 cases, T2 period of 13 cases, T3 period of 15 cases, T4 period of 14 cases. CT of gastric cancer in stages T1 ~ T4 accuracy of diagnosis are as follows: 66.6%, 73.2%, 78.3%, 75%, with a total accuracy of 72.2%. Of CT and pathologic staging of the consistency of test results (Kappa test), Kappa value of 0.70,, that T-staging results of CT and pathologic results were better consistency and repeatability, have important clinical reference价值. 50 cases of radical surgery of gastric cancer and gastric lymph node dissection weeks in each group, surgical removal of a total of 323 lymph nodes; CT detected 269 lymph nodes, pathologically confirmed lymph node metastasis of 123. The diameter of the scope of its distribution in Table 3.2. D "5mm transfer positive rate of 17.4%, 5mm |
PDF Full Text Request