2015 年第 4 期 第 13 卷

MSCT对进展期胃癌和胃淋巴瘤的鉴别诊断价值

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关键词：胃癌胃淋巴瘤x线计算机体层摄影术

• 摘要：
• 【摘要】摘要 目的 探讨多层螺旋CT（MSCT）在进展期胃癌和胃淋巴瘤鉴别诊断中的价值。方法 对46例进展期胃癌和34例胃淋巴瘤患者进行MSCT平扫和增强扫描。比较两种肿瘤的胃侵犯部位、胃壁、胃黏膜及胃腔改变情况、周围组织或器官的浸润或转移、中上腹部淋巴结转移情况。结果 进展期胃癌组多部位侵犯14例，增强扫描不均匀强化28例，胃黏膜中断、破坏24例，胃腔狭窄、近侧胃腔扩张14例，腹主动脉周围下部淋巴结转移18例，胃淋巴瘤组多部位侵犯24例，增强扫描不均匀强化7例，胃黏膜中断、破坏5例，胃腔狭窄、近侧胃腔扩张3例，腹主动脉周围下部淋巴结转移23例，两组上述指标差异有统计学意义。进展期胃癌组和为淋巴瘤组在胃壁厚度、肿瘤外侵和器官转移、平均淋巴结转移的部位数差异无统计学意义。结论 MSCT在进展期胃癌和胃淋巴瘤的鉴别诊断中具有重要临床价值。
• Abstract Objective To investigate differential diagnostic value of multi slice spiral CT (MSCT) on advanced gastric cancer and gastric lymphoma. Methods 46 patients with advanced gastric cancer and 34 patients with gastric lymphoma underwent MSCT plain scan and enhanced scan. Compared the changes of the stomach invasion site, stomach wall, stomach gastric mucosa and gastric cavity, the surrounding tissue or organ infiltration or metastasis and upper abdominal lymph node metastasis of two kinds of tumors. Results 14 cases invaded multiple sites in the advanced gastric cancer group, 28 cases were inhomogeneous enhanced and 24 cases had gastric mucosa interrupted and destroyed, 14 cases had stenosis of stomach, proximal gastric lumen dilatation, 18 cases had lower abdominal paraaortic lymph node metastasis. 24 cases had multiple sites invaded in the gastric lymphoma group, 7 cases were inhomogeneous enhanced, 5 cases had gastric mucosa interrupted and destroyed, 3 cases had stenosis of stomach, 23 cases had lower abdominal paraaortic lymph node metastasis, there were statistically significant differences in above indexes between the two groups . There were not statistically significant differences in the gastric wall thickness, invasion of tumor and metastasis of organ, the average number of lymph node metastasis sites. Conclusion MSCT has important clinical value in differential diagnosis of gastric cancer and gastric lymphoma.