胃癌影像学分期与评效--多学科诊疗的需求与对策  

Staging and response evaluation of gastric cancer：requirements and resolutions by multidisciplinary treatment

作　　者：唐磊[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华胃肠外科杂志》2015年第3期208-212,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金（81201215，81371715）；北京市自然科学基金（7132039）；北京大学-清华大学生命科学联合中心临床研究人才项目

摘　　要：多学科诊疗模式对胃癌的影像学评价提出了更高要求，涵盖从分期到评效的多个层面。受到分辨率制约，目前各种影像学手段均无法显示胃的浆膜结构，联合浆膜面“亮线征”或可间接提高胃癌侵出浆膜的判断准确率；能谱CT和磁共振扩散加权成像则可能为胃癌的分期评价提供具有潜力的新手段。胃癌CT评价时，应重视癌肿在脂肪间隙内弥散浸润并广泛侵犯周围脏器所导致的不可切除征象。评价腹膜转移时要注意观察位置的全面性，并关注一些可能提示腹膜转移的早期征象。磁共振扩散加权成像可能为胃癌放化疗的疗效评价提供新的指标，辅助解决胃癌新辅助化疗无合适形态学靶病灶的问题。The popularization of the multidisciplinary treatment has brought more demands to the radiological evaluation of the gastric cancer, which includes staging and response evaluation. Limited by the resolution, the present imaging modalities can not demonstrate tiny structures of the serosa, and the employment of the hyperattenuating serosa sign may improve the diagnostic performance of T4a. The spectral CT and diffusion weighted MRI may provide new potential methods for the staging of gastric cancer. Attention should be paid to the unresectable signs caused by the dispersed infiltration of adjacent fat space to the organs. The comprehensive evaluation of peritoneal metastasis should base on the sites and early signs. Diffusion weighted MRI may provide new indicator for the response evaluation of gastric cancer to neoadjuvant chemotherapy.

关 键 词：胃肿瘤 体层摄影术 X线计算机 磁共振成像 肿瘤分期 疗效评价 

分 类 号：R735.2[医药卫生—肿瘤]