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目的探讨胃癌侵犯胃裸区(GBA)的CT表现和解剖病理基础。方法回顾性分析110例近侧胃癌(PGC)连续性病例的CT资料,其中外科手术和病理证实GBA受到肿瘤侵犯46例。观察胃癌侵犯GBA的CT表现特征,分析CT征象的解剖病理基础。结果46例中有38例表现为GBA内软组织肿块,8例表现为结节状淋巴结。胃癌侵犯GBA病例的CT征象有(1)GBA增宽,胃壁与膈肌之间的薄层脂肪间隙中断或消失(36例)。(2)GBA内可见不均匀强化的软组织密度肿块(38例)或类圆形淋巴结(8例)。(3)左膈脚及胃膈韧带不规则增厚并与肿瘤分界不清(25例)。(4)膈下腹膜后间隙其他转移性淋巴结肿大(3例)。结论胃癌侵犯GBA有一定的CT表现特征。解剖位置和淋巴引流是PGC侵犯GBA的重要原因,并且可能与PGC的预后较差有关。
Objective To investigate the CT findings and anatomic pathology of gastric cancer invading GBA. Methods The CT data of 110 patients with proximal gastric cancer (PGC) were analyzed retrospectively. Among them, 46 cases of GBA were confirmed by surgery and pathology. Observe the CT features of GBA invaded by gastric cancer and analyze the anatomical and pathological basis of CT signs. Results In 46 cases, 38 cases showed soft tissue mass in GBA and 8 cases showed nodal lymph nodes. There are (1) GBA widening in the CT signs of gastric cancer invasion GBA, and the thin fat gap between the stomach wall and the diaphragm is interrupted or disappeared (36 cases). (2) In 38 cases with uneven soft tissue density (GBC) or round lymph nodes (8 cases) in GBA. (3) The left phrenic foot and the diaphragm diaphragm irregular thickening and tumor demarcation (25 cases). (4) subretinal retroperitoneal space other metastatic lymph nodes (3 cases). Conclusion GBA has some CT features of gastric cancer. Anatomy and lymphatic drainage are important causes of PGC invasion of GBA and may be related to the poor prognosis of PGC.