采用气体对比剂行胃螺旋CT扫描在胃癌诊断中的价值  

The value of spiral CT in the diagnosis of gastric carcinoma adopting gas contrast medium

作　　者：李冬梅[1] 吴非[1] 李智勇[2] 伍建林[2] 

机构地区：[1]大连市中医医院放射科,辽宁大连116013 [2]大连医科大学附属第一医院放射科,辽宁大连116011

出　　处：《医学影像学杂志》2004年第9期705-707,共3页Journal of Medical Imaging

摘　　要：目的 :探讨采用气体对比剂行胃的螺旋CT检查在胃癌诊断中的应用价值。方法 :对 4 6例胃癌病例行气体对比螺旋CT扫描 ,男 36例 ,女 1 0例 ,平均年龄 5 7岁。 4 6例胃癌均经手术和病理证实 ,其中早期胃癌 7例 ,进展期 39例。CT机为SHIMADZU - 6 80 0TX ,检查前 1 0min肌注 6 5 4 - 2 2 0mg ,口服产气剂 3～ 6g作为对比剂 ,均采用仰卧及俯卧两种体位。结果 :检出病变位于胃窦部 2 3例 (5 0 %) ,胃底贲门部 9例 (1 9.5 %) ,体部 6例 (占 1 3.0 %) ,弥漫型 8例 (1 7.5 %) ,病变检出率为 1 0 0 %。CT表现为局限性胃壁增厚 5例 ,广泛性胃壁增厚 (病变最大径 >4cm) 4 1例 ;软组织肿块 1 9例 ;病变向周围直接侵犯 2 6例 ;局部和远处淋巴结转移 1 9例 ;远处转移 2 1例 ;本组CT定性诊断准确率为 96 %。结论 :CT密度分辨率高 ,可清晰显示胃壁及腔内、外病变 ,并直观反映胃癌大体形态及肿瘤的范围。采用气体对比剂的胃单层螺旋CT扫描同样在胃癌的定位、定性和定量诊断中具有重要的作用 ,尤其对中小医院值得推广。Objective:To explore the value of spiral CT in the diagnosis of gastric carcinoma adopting gas contrast medium.Methods:Forty six patients with gastric carcinoma did spiral CT examination adopting gas contrast medium,thirty six and ten cases are men and women,fifty seven years on the average.All cases were confirmed either by surgiopathology or by endoscopic biopsy,of which seven and thirty nine cases with gastric carcinoma were early and advanced.The scans were obtained with a SHIMADZU SCT/6800TX scanner.Intramuscular injection of hypotonic agent (654～2 20mg) was done ten minutes before the examination and the patients were all asked to take the medicine (3～6g) with a little water which will output gas as oral contrast medium.All case were scanned by supine and prone.Results:In these 46 cases,there were 23 examples (50%) locating the gastric antra,stomach bottom cardia 9 cases (19.5%),gastric body 6 cases (occupy 13.0%),widespread type 8 examples (17.5%),SCT accuracy of discovering the gastric lesions reached to 100%.CT manifestation:gastric wall confining thickened in 5 cases and extensive thickened in 41 cases (biggest path of the lesions>4cm);Soft tissue mass 19 cases;The pathological changes are direct to surroundings to infringe upon 26 cases;The part transfer with lymphoid node in distant place 19 cases;The distant place transfers 21 cases;SCT accuracy of determining the nature of the lesion reached to 96%.Conclusion:CT has high density resolution and can display lesions in the gastric wall,inside and outside cavity clearly,it also can reflect shape and extension of the tumor directly.Spiral CT of single layer of stomach scan adopting gas contrast medium play an important role in the locating,qualitative and quantifing of gastric carcinoma,particularly to middle and small scale hospitals.

关 键 词：胃癌 诊断 体层摄影术 X线计算机 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]