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目的回顾性分析胃癌患者的64排螺旋CT表现特点,评价64排螺旋CT扫描胃癌征象与病理TN分期相关性。方法通过影像归档和通信系统(PACS)收集苏州大学附属第二医院2008年4月至2013年9月收治的503例经手术病理证实并行64排CT检查的胃癌病例,由两名高年资影像科医师在ADW4.3工作站对图像重建与观察,观察病灶长度和厚度、部位、大体形态、病灶强化程度、浆膜征象,分析胃癌CT征象与病理TN分期相关性。结果 503例胃癌病灶长度为(57.3±22.7)mm;厚度(12.6±5.2)mm。胃癌长度和厚度与病理TN分期有相关性(P<0.01)。好发部位为胃窦及胃底贲门部。大体类型为蕈样型胃癌最常见。胃癌的发生部位与胃癌T分期无相关性(P>0.05),与N分期有相关性(P<0.01)。胃癌大体形态与胃癌病理TN分期间无相关性(P均>0.05)。胃癌不同病理T分期病灶平扫和动脉期CT值差异均无统计学意义(P>0.05),病灶静脉期和延迟期CT值间的差异具有统计学意义(P均<0.01)。胃周脂肪模糊在T3期中最为常见(87.95%);T1、T2期中无浆膜高强化征,T4期浆膜高强化征发生率50.00%。浆膜征象与胃癌的T分期具有相关性(P<0.05)。结论胃癌64排CT征象与病理TN分期有统计学意义上的相关性。
Objective To retrospectively analyze the features of 64-slice spiral CT in patients with gastric cancer, and to evaluate the correlation between the signs of gastric cancer and the pathological TN staging by 64-slice spiral CT. Methods A total of 503 cases of gastric cancer confirmed by pathology and confirmed by 64-slice CT in the Second Affiliated Hospital of Soochow University from April 2008 to September 2013 were collected by image archiving and communication system (PACS). Two high-risk images The physicians reconstructed and observed the images on the ADW4.3 workstation, and observed the length, thickness, location, general morphology, lesion enhancement and serosal signs of the lesion, and analyzed the correlation between CT signs and pathological TN staging in gastric cancer. Results The length of 503 gastric cancer lesions was (57.3 ± 22.7) mm and the thickness was (12.6 ± 5.2) mm. The length and thickness of gastric cancer were correlated with TN staging (P <0.01). A good site for gastric antrum and gastric cardia department. The general type of mycosis is the most common form of gastric cancer. There was no correlation between the occurrence of gastric cancer and T staging of gastric cancer (P> 0.05), and the correlation with the N stage (P <0.01). There was no correlation between the general morphology of gastric cancer and TN pathology (all P> 0.05). There was no significant difference in CT value between T stage and T stage of gastric cancer (P> 0.05). The differences of CT value between the venous phase and the delayed stage were statistically significant (all P <0.01). The peritumoral fat fuzzy was the most common in T3 (87.95%), while in T1 and T2, there was no signs of hyperosteogeny and the incidence of T4 hyperemia was 50.00%. Serosal signs correlated with T staging of gastric cancer (P <0.05). Conclusion There is a statistically significant correlation between 64-slice CT findings and TN staging in gastric cancer.