Controlled Trail Of256Multislice CT Preoperative Assessment And Pathological Findings On T Staging Of Gastric Carcinoma

Objective：This research is aimed at evaluating the role of imaging using256multislice CT with drug-induced hypotonia and water filling in stagingof gastric carcinoma and preoperative assessment.Methods：According to AJCC2010staging of gastric carcinoma，preoperative Tstaging of68cases of gastric cancer confirmed pathologically wasperformed with256spiral CT triphasic scanning，and the resluts of CT Tstaging under different window width were compared with pathological Tstaging after surgery.Results:Each lesion was well performed using256spiral CT under the conditionsof triphasic enhancement.Window Level45Hu，Window Width200Hu，theaccuracy of T1、T2、T3、T4staging with multislice CT was36.36%(4/11)、40.00%(6/15)、62.50%(15/24)and83.33%(15/18).The total accuracy of T staging was58.82%(40/68) respectively. By twoof sample differences rate test， the difference of staging accuracybetween T1and T4、T2and T4had statistical significance（P<0.05），all ofCT T stagings were correlated with pathological findings moderately （kappa value was0.429）.Window Level45Hu，Window Width400Hu，the each accuracy from T1to T4was36.36%（4/11）、46.67%（7/15）、75.00%（20/24）、88.89%（16/18），respectively.The difference of accuracybetween T1and T3、T1and T4、T2and T4staging had statisticalsignificance（P<0.05）.Under this reading condition,MSCT T staging waswell correlated with pathological T staging(kappa vaule was0.609).The rateof serosal invasion was69.49%、80.00%、100%when setting10mm、15mmand20mm as the threshold of gastric wall thickness，respectively，thedifference between the rate of serosal invasion with threshold15mm and20mm had statistical significance（X2=2.663，P<0.05）.Conclusion：1.There was correlation between multislice CT features and operativepathology，MSCT can be used as a effective technique for preoperative Tstaging，under the condition of larger window width，CT T staging was wellcorrelated with pathological T staging.2.The deeper the gastric cancer infringing the stomach wall， thehigher of MSCT T staging accuracy.3.With Window Level45Hu，increasing the Window Widthappropriately，it is donductive to enhance the accuracy of T3staging.4.With setting15mm as the threshold of gastric wall thickness，thethicker the wall is，the higher the rate of serosal invasion is.