Chen M C, Tsang Y M, Kung C H, Chang R H, Hsu J C, Su C T, Wang D H, Wei T C
Department of Radiology National Taiwan University, Medical College and Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1993 Sep;92 Suppl 3:S140-5.
To overcome the problem of poor mixing of gastrointestinal tract contents with a diluted iodinated contrast agent in abdominal computed tomography, pure water was adopted as an oral contrast agent. In 25 cases of clinically suspected gastric carcinoma, a subsequent pathological examination revealed six cases of early gastric cancer and 19 cases of advanced gastric cancer. We performed CT of the stomach using the following revised procedure: patients were given 600-1000 mL of water by mouth after an intramuscular dose of Buscopan to distend and immobilize the stomach. Gastric mucosal enhancement and the poorer enhanced submucosal layer were demonstrated by a bolus intravenous injection of iodine-containing contrast medium using an automatic injector synchronized with the CT machine. Based on abnormal gastric wall thickening and the abnormal mural enhancement patterns, an accuracy of 96% was attained in differentiating early gastric cancer from advanced gastric cancer, but the detection rates for extragastric invasion, gastric ulcers and lymphadenopathy were 67%, 43% and 63%, respectively. CT staging of gastric cancer was 72%, and was especially accurate for stages I and IV. Water as oral contrast agent for CT of the GI tract was readily accepted by patients and caused no side effects. Using water as an oral contrast for gastric CT is of great help in staging gastric cancer.
为克服腹部计算机断层扫描中胃肠道内容物与稀释碘化造影剂混合不佳的问题，采用纯水作为口服造影剂。在25例临床疑似胃癌患者中，后续病理检查显示早期胃癌6例，进展期胃癌19例。我们采用以下改良方法进行胃CT检查：肌肉注射解痉灵后，患者口服600 - 1000 mL水以扩张并固定胃。使用与CT机同步的自动注射器静脉推注含碘造影剂，显示胃黏膜强化及强化较差的黏膜下层。基于胃壁增厚异常及壁强化模式异常，鉴别早期胃癌与进展期胃癌的准确率达96%，但胃外侵犯、胃溃疡及淋巴结病的检出率分别为67%、43%和63%。胃癌的CT分期准确率为72%，对I期和IV期尤其准确。水作为胃肠道CT的口服造影剂易被患者接受且无副作用。用水作为胃CT的口服造影剂对胃癌分期有很大帮助。
