目的：探讨多层螺旋CT（MSCT）增强扫描及血管造影在胃癌诊断及肿瘤血供中的应用价值。方法收集近2年在我院经手术病理证实为胃癌38例患者的64层螺旋CT双期增强扫描及血管造影图像，分析胃癌的CT征象及CT血管造影对胃癌供血的显示，与术中所见及术后病理进行对照。结果64层螺旋CT双期增强扫描诊断胃癌，显示胃壁厚度、胃壁外软组织肿块及胃壁溃疡大小与术后证实差异无统计学意义；病理诊断为低分化腺癌的胃壁厚度、胃壁外软组织肿块及胃壁溃疡大小、区域淋巴结转移率与中分化腺癌的差异有统计学意义。血管造影腹腔干、肝固有动脉，胃左动脉、胃右动脉及胃网膜右动脉在容积再现（VR）上能够很清晰地显示；最大密度投影（MIP）显示细小血管较好，但是它在表现三维空间关系上不如VR。结论 MSCT双期增强扫描对胃癌有较高的诊断价值，血管造影在肿瘤血供显示有较高价值。%Objective To investigate the value of enhanced and angiography MSCT in gastric cancer diagnosis and tumor blood supply display. Methods Two-phase enhanced scan and angiography images with 64-slice spiral CT in 38 patients with gastric cancer confirmed by pathology were compared with operative findings and pathological ex-amination in our hospital. Results The difference of the stomach wall thickness,mass and ulcer size between CT findings and postoperative specimen had no significance. The difference of the stomach wall thickness ,mass and ulcer size,regional lymph node metastasis rate between poorly differentiated adenocarcinoma and well-differentiated adeno-carcinoma pathologically was statistically significant. Celiac trunk, hepatic artery, left gastric artery, right gastric artery and right gastroepiploic artery were very clear on the VR (volume rendering) of angiography. MIP (maximum intensity projection) displayed the small blood vessels. However, it was not as good as VR on the performance of the three-di-mensional relationship. Conclusion MSCT two-phase enhanced scan have a higher diagnostic value for gastric can-cer,and angiography could display the tumor blood supply very well.
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