多层螺旋CT 对胃黏液和非黏液腺癌的鉴别诊断价值

摘要

Objective To evaluate multidetector row CT (MDCT ) characteristics in the differentiation of mucinous and nonmucinous gastric carcinomas. Methods In 63 patients with pathologically proved mucinous (n=21) or nonmucinous (n=42) gastric carcinomas, dynamic enhanced MDCT images were obtained. The predominant thickened layer, contrast enhancement pattern, and degree of enhancement were retrospectively evaluated. Results The most common contrast en-hancement pattern was layered (16/21) in mucinous carcinomas and homogeneous (30/42) in nonmucinous carcinomas, which was significantly different (χ²=12. 8571, P=0. 0003). The predominantly affected thickened layer was the low-at-tenuating middle or outer layer (15/21) in mucinous carcinomas and the high-attenuating inner layer or the entire layer (31/42) in nonmucinous carcinomas, which was significantly different (χ²=11. 8207, P =0. 0006). Only 5 (5/21) mu-cinous tumors were shoun calcifications. Conclusion MDCT is helpful to distinguish between mucinous and nonmucinous gastric carcinomas.%目的：评价多层螺旋CT（multidetector row CT ，MDCT）对胃黏液与非黏液腺癌的鉴别诊断价值。方法搜集经手术切除后病理证实的胃黏液腺癌21例、非黏液腺癌42例，术前均运用多层螺旋C T行双期扫描，着重观察增厚的胃壁、强化的方式和强化程度等。结果黏液腺癌强化常呈分层强化（16/21），而非黏液腺癌常呈均匀强化（30/42），两组比较差异有统计学意义（χ²＝12．8571，P＝0．0003）。黏液腺癌胃壁增厚主要为低密度的中层或外层（15/21）而非黏液腺癌增厚的胃壁主要为高密度的内层或全层（31/42），差异有统计学意义（χ²＝11．8207， P ＝0．0006）。5例（5/21）黏液腺癌内见钙化形成。结论多层螺旋CT对鉴别胃黏液与非黏液腺癌有一定价值。