多层螺旋CT对胃常见恶性肿瘤的诊断价值

摘要

Objective:To retrospectively analyze the CT features among gastric cancer, gastric lymphoma and gastric malignant stromal tumors, evaluated the application value of MDCT in gastric malignant tumor.Methods: Sixty two patients with gastric malignancies tumor confirmed by pathology underwent MDCT plain scanning and triphasic contrasted scanning before operation. Referring to the pathological results, to observe the CT signs, include: scope of tumors and involvement, the density of tumors and enhanced characteristics, mucosal membrane, the change of the stomach softness, peripheral lymph node enlargement, the involvement of other organs, and to make statistical analysis for imaging features of these tumors byx2 testing.Results: Sixty two cases of gastric malignant tumor included 42 cases of gastric carcinoma, 12 cases of gastric lymphoma and 8 cases of gastric malignant stromal tumor, were confirmed by postoperative pathology. The CT manifestations were as follows: the stomach mucous membrane surface involvement in all the gastric cancer, the positive rate was significantly higher than gastric lymphoma and stromal tumor. The area involved by lymphoma were more than two partitions, significantly higher than that of gastric cancer and stromal tumor (x2=36.643,x2=20.00;P<0.05). 39 cases (92.8%) of gastric cancer and 8 cases (100%) of malignant stromal tumors were significantly enhanced, but all gastric lymphoma were not obvious enhancement. The positive rate of enlarged lymph nodes in gastric cancer(61.9%) and lymphoma(83.3%) were higher than stromal tumor(12.5%)(x2=9.731,x2=6.603;P<0.05).Conclusion: The CT manifestations of the gastric cancer, lymphoma, malignant stromal tumors had different characteristics. Multislice CT for the diagnosis and differential diagnosis of gastric malignant tumor has important value.%目的：回顾性分析经病理学确诊的胃癌、胃淋巴瘤及胃恶性间质瘤的CT表现，探讨常见恶性肿瘤的特征性CT征象，评价多层螺旋CT(MSCT)在胃恶性肿瘤诊断中的应用价值。方法：选取62例经病理证实为胃恶性肿瘤的患者，术前均行MSCT平扫及三期增强扫描，对照病理结果，观察其CT征象。内容包括病变部位及累及范围、病变密度及强化特点、黏膜面改变、胃壁柔软度的改变、周围淋巴结肿大以及其他脏器受累情况，并采用x2检验对各种肿瘤的影像学表现进行统计学分析。结果：胃恶性肿瘤62例，其中包括胃癌42例、胃淋巴瘤12例及胃恶性间质瘤8例，均经术后病理证实。CT表现为：所有胃癌患者均有黏膜面累及，显著高于胃淋巴瘤及间质瘤；所有胃淋巴瘤均侵犯胃2个以上分区，并显著高于胃癌及间质瘤，差异有统计学意义(x2=36.643， x2=20.00；P＜0.05)。胃癌39例(占92.8%)及恶性间质瘤明显强化8例(占100%)，所有胃淋巴瘤均轻度强化。淋巴结肿大在胃癌中占61.9%，淋巴瘤中占83.3%，两者阳性率均高于间质瘤(占12.5%)，其差异有统计学意义(x2=9.731，x2=6.603；P＜0.05)。结论：胃癌、胃淋巴瘤及胃恶性间质瘤的MSCT表现各有独自的特点，而MSCT对胃恶性肿瘤的诊断及鉴别诊断有重要价值。