Lee Mi Hee, Choi Dongil, Park Min Jung, Lee Min Woo
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-Ku, Seoul, Republic of Korea.
Abdom Imaging. 2012 Aug;37(4):531-40. doi: 10.1007/s00261-011-9780-3.
Gastric cancer is a common deadly cancer worldwide. The tumor-node-metastasis (TNM) staging system is one of the most commonly used staging systems, and is accepted and maintained by the International Union against Cancer (UICC) and the American Joint Committee on Cancer (AJCC). The TNM system is well known to effectively predict the prognosis of gastric cancer patients. The latest revision of TNM staging was presented in the 7th edition of the AJCC in 2009. Multi-detector row CT (MDCT) is a powerful test for non-invasive evaluation and can assess metastatic and locoregional staging simultaneously. Current MDCT with isotropic imaging and 3D images has increased the accuracy of T and N staging in patients with gastric cancer. Multi-planar reformatted images permit the radiologist to select the optimal imaging plane to accurately evaluate tumor invasion depth of the gastric wall and perigastric infiltration to identify a fat plane between a tumor and adjacent organs, to avoid partial volume averaging effects, and to differentiate lymph nodes from small perigastric vessels. Thus, MDCT provides a useful all-in-one diagnostic method for the pre-operative evaluation of patients with known, or strongly suspected, gastric cancer according to the 7th AJCC TNM staging system.
胃癌是全球常见的致命性癌症。肿瘤-淋巴结-转移（TNM）分期系统是最常用的分期系统之一，被国际抗癌联盟（UICC）和美国癌症联合委员会（AJCC）所接受并沿用。众所周知，TNM系统能有效预测胃癌患者的预后。TNM分期的最新修订版于2009年在AJCC第7版中发布。多排螺旋CT（MDCT）是一种用于无创评估的强大检查手段，可同时评估转移情况和局部区域分期。当前具备各向同性成像和三维图像的MDCT提高了胃癌患者T分期和N分期的准确性。多平面重组图像使放射科医生能够选择最佳成像平面，以准确评估胃壁肿瘤浸润深度和胃周浸润情况，从而识别肿瘤与相邻器官之间的脂肪平面，避免部分容积平均效应，并区分胃周小血管与淋巴结。因此，根据第7版AJCC TNM分期系统，MDCT为已知或高度怀疑患有胃癌的患者提供了一种实用的一体化术前评估诊断方法。
