| ObjectiveThis study take advantage of spiral computer tomography (SCT) on prior - researchers base, to pay an important attention on showing SCT enhanced character and serous coat invaded of stomach cancer to detect its value of diagnosing serous coat invaded of stomach cancer.Material and MethodsWe have selected 36 cases of advanced stomach cancer patients diagnosed by gastrpscope, including 21 male and 15 female patients. The ages of the patients is from 32 to 72 and average age is 56. 31 . Their pathologic diagnoses are as follows: 20 low - differentiated ade-nocarcinomas, 7 well - differentiated adenocarcinomas, 3 signet -ring - cell carcinomas, 4 mucous adenocarcinomas, 1 adeno - squ-mous carcinomas and 1 undifferentiated carcinomas.We have used SCT instrument named TOSHIBA X press /GX. Before scanning, the patients must be hungry, be injected 654 - 2 10mg, and must drink 600 - 1000 ml water when they feel thirsty. Enhanced CT scanning use Onipac contrast media ( 300mgl/ml) , whose rejecting rate is 2.5 -3 ml /s. After injecting, we made scanning separately in 25 seconds and 60 -70seconds, which is named arterial phase and venous phase. Raw data were reconstructed by 1mm slice and were observed.All images were blindly observed by two professors. Content observed is as follows: (1) whether the local serous coat is lubricate, (2) the changes of adjacent fat spaces, (3) whether there are Blumer's shelf on the brim of the neoplasm, (4) the enhanced effects of the neoplasms. When we judge the frontal 3 contents, our results must have at least 2 sustaining images from ordinary scanning, arterial phase scanning and venous phase scanning images.In guidance of a skilled doctor in pathological department, we cut down specimens. The specimens were fixed and the central parts were fetched. After embedding by olefin, the material was cut as 4 - m slices and was made HE staining. A skilled doctor in pathological department observed the sections and drew a conclusion.We have observed the characters in connexion with advanced stomach cancer infiltrating its local serous coat, contrasting with pathological diagnoses, computed the positive rate, specificity and sensitivity of each characters. Depending on the enhanced effects of the neoplasms, we computed the ratio of the cases of neoplasms infiltrating their local serous coat. Using the SPSS software, we tested the differences in the rates of local serous coats infiltrated between the enhanced effects of neoplasms by x2- We consent there are obvious differences when the value of P is below 0.05.Result1. Image characters of advanced stomach cancer s local serous and its relationship with local serous infiltratedAccording to arterial and venous phase of enhance CT in 36 cases, images show as follows: 23 cases had rough serous and 13cases had smooth serous; 24 cases had rough fat space and 12 cases had clear fat space; in 5 cases, the neoplasms had Blumers shelf, and in other 31 cases, the neoplasms had none. By pathological diagnoses, there are 20 cases whose serous had been infiltrated and 16 caseswhose serous had not been infiltrated. The sensitivity, specificity and accuracy of the rough serous to judge the serous infiltrated separately is 90% , 68.75% and 80.56%. The sensitivity, specificity and accuracy of the rough fat space to judge the serous infiltrated separately is 70% , 37. 50% and 55.56%. The sensitivity, specificity and accuracy of the turner's shelf to judge the serous infiltrated separately is 25%, 100% and 58.33%.2. Image showings of enhamced spiral CT of advanced stomach cancer and its relationship with local serous infiltratedIn the 36 cases, during arterial phase, 9 cases (25. 0% ) show the neoplasms reaching to stomach cavity with line - shape enhancements , which included 5 well - differentiated adenocarcinomas and 4 mucous adenocarcinomas; 15 cases (41.67%) show disordered enhancements, which included 10 low -differentiated adenocarcinomas, 2 well - differentiated adenocarcinomas and 3 signet - ring - cel... |
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