胃癌壁内浸润：水充盈法CT评估

Intramural invasion of gastric cancer: evaluation by CT with water-filling method.

作者信息

Tsuda K, Hori S, Murakami T, Nakamura H, Tomoda K, Nakanishi K, Shiozaki H

机构信息

Department of Radiology, Osaka University Medical School, Japan.

出版信息

J Comput Assist Tomogr. 1995 Nov-Dec;19(6):941-7. doi: 10.1097/00004728-199511000-00019.

DOI:10.1097/00004728-199511000-00019

PMID:8537530

Abstract

OBJECTIVE

Our goal was to clarify the ability of CT to evaluate intramural invasion of gastric cancer.

MATERIALS AND METHODS

We reviewed bolus-enhanced CT images performed with orally administered 400-600 ml of water in 59 early gastric cancers and 22 advanced gastric cancers mimicking early gastric cancers macroscopically.

RESULTS

CT was able to reveal 49% of early gastric cancers and 68% of advanced gastric cancers mimicking early cancers. Twenty-seven gastric tumors were detected in two or three layered structure of wall. Morphologic features of early gastric cancers are strong enhancement without wall thickening and thickened inner layer with normal middle and outer layers. Morphologic features of early advanced gastric cancers are a thickened wall with disappeared middle and outer layers and transmural enhancement with wall thickening. If one of these features was used to predict whether the tumor was early or early advanced gastric cancer in detected cases, specificity was 93-100%, sensitivity was 7-72%, and positive predictive value was 80-100%.

CONCLUSION

We evaluated whether the wall pattern of gastric tumors on CT can provide useful information about intramural invasion.

摘要

目的

我们的目标是阐明CT评估胃癌壁内浸润的能力。

材料与方法

我们回顾了59例早期胃癌和22例宏观上类似早期胃癌的进展期胃癌口服400 - 600 ml水后进行的团注增强CT图像。

结果

CT能够显示49%的早期胃癌和68%宏观上类似早期胃癌的进展期胃癌。27个胃肿瘤在胃壁的两或三层结构中被检测到。早期胃癌的形态学特征是强化明显但无胃壁增厚，内层增厚而中层和外层正常。早期进展期胃癌的形态学特征是胃壁增厚，中层和外层消失，伴有壁增厚的透壁强化。如果在检测到的病例中使用这些特征之一来预测肿瘤是早期胃癌还是早期进展期胃癌，特异性为93 - 100%，敏感性为7 - 72%，阳性预测值为80 - 100%。