| Gastric cancer is the most common cancer in digestive system.It issecond cancer at the cancer incidence and death rate.Barium mealexamination and endoscopy are two main methods to diagnose gastriccancer now. With the development and application of medicaltechnology and some advanced treatment in clinic, it is more importantfor clinic to evaluate staging before operation. Muti-slice spiralCT(MSCT) is valuable for diagnosing invasion depth into stomachwall,fat spaces around,and situation of lymph node metastasisaround,which makes the pre-operation staging of gastric cancer moreprecise. We judge gastric cancer’s shape, size and boundary based onimages which can show different tissues’ density from MSCT, at thesame time, diagnosing invasion depth into fat space is based on thesmooth of serosa, fat space’s thickness, density and fog-level aroundstomach. Based on traditional CT,spectral CT imaging transformed fromsingle parameter imaging to multi-parameter,from mix-energy topoly-energy ones,what bring us into a new and quantitativefield.Nowadays,traditional imaging examination methods has been mature,the reacher of spectral CT about gastric cancer is being hottopics.Objective:By quantitative evaluate gastric cancer wall and itsinfiltration under single-energy curve，iodine content of GSI，providingmore overall information for clinical doctors in distinguishingresection range，making rational operation plan.Materials And Methods: Materials And Methods:50patients withgastric cancer from the first hospital of JiLin University from Novemberof2011to December of2012;43male,27female,aging from36to70years old, average55;All of them did surgery,and gotpathological diagnosis. Among them, the number of invasive GC is36, and nodular GC is14; there are42cases whose fat space getsinvaded,3cases are inflammatory and5normal. All50patients gotplain and two phases scan technology with Discovery CT750(HDCT)under GSI was open. All the patients were prepared with liquid foodthe night before scanning, abrosia12h before scanning, intramuscular654-2of20mg except patients with glaucoma,BPH and tachycardia;patients drunk water800-1000ml15minutes before scaning. Maintainedat supine position,Patients were scanned from top diaphragm to anteriorsuperior iliac spine.Inject88ml nonionic contrast medium----Ounaipaike300via embow vein by high pressure injector,3.0ml/s,andsubsequently10ml saline,3.0ml／s. And scan separatetly after30s and60s.After scanning，reconstruct in slice1.25mm/0.625mm, transport toAW4.2（Advantage Workstation4.2，GE Medical systems) and deal withMPR.Analyse only-energy curve， iodide and water content，and CTvalue of AP and VP images of GSI.By SPSS18.0software package,analysis the differentiation of the quantitation of based iodinecontent,based water content and CT number under101energy decaycurve slope from40to140keV,among cancer wall in different stage ofgastric cancer,normal gastric wall and fat spaces，and then compared bypathology after surgery.Result：At arterial and venous phasey,through comparision among101energy decay curve slope from40to140keV, the quantitation ofbased iodine content,and CT number at different KeV,It is statisticallysignificant to evaluate between gastric wall with cancer cell infiltrationand the normal ones,,and equally applies to the infiltrated fat and thenormal.While the content of based water is meaningless among them.Conclusion： Gemstone spectral imaging is significant fordistinguishing between the gastric wall with cancer cell infiltration andthe normal,and the same for infiltrated fat and the normal. It is moreaccurate to differentiate the gastric cancer wall and normalones,infiltrated fat and the normal by the Energy decay curve slope ofGSI,iodine content and low-energy-CT number.Thus providing moreimaging details and objective data for clinicians to evaluate operationdifficulty，choose and make operative plans and then improve operationaccuracy。... |
PDF Full Text Request