Value of Multi-Slice Computer Tomography in Diagnosis and Preoperative TNM Staging of Gastric Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Juan ¹ , PAN Yanchen ² , ZHOU Xiangping ¹ , SONG Bin ¹ , YAO Jin ¹

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Stomach neoplasm; Tomography/X-ray computer; Neoplastic stage

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Objective　 To evaluate the value of plain and dual-phasic enhanced 16-slice CT in the diagnosis and preoperative TNM staging of the gastric carcinoma, and to discuss the relationship between image signs and pathologic findings.
Methods 　Fifty-three cases of the gastric carcinoma confirmed histopathologically underwent 16-slice CT examination. The scan protocol included plain scanning, the arterial phase and portal venous phase scanning. The manifestation of the three series images and multiplanar reconstruction (MPR) images were analyzed.
Results 　①The accuracies of 16-slice CT for the T stage, the N stage and the M stage of the gastric carcinoma were 83.02%, 80.00% and 92.45% respectively. ②The overall accuracy of 16-slice CT for judging TNM stage was 84.91%.
Conclusion 　The plain scan and dual phase enhanced scans of 16-slice CT, especially the thin slice and MPR with proper windows technique are helpful for the diagnosis of gastric carcinoma and the TNM stage, which is useful for the selection of the operative project and the therapy plan.

Citation： HUANG Juan,PAN Yanchen,ZHOU Xiangping,SONG Bin,YAO Jin. Value of Multi-Slice Computer Tomography in Diagnosis and Preoperative TNM Staging of Gastric Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(6): 717-721. doi: Copy

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12.	Minami M, Kawauchi N, Ltai Y, et al. Gastric tumors: radioligic-pathologic correlation and accuracy of T staging of T staging with dynamic CT [J]. Radiology, 1992; 185(1)∶173.
13.	胡建昆，陈志新，张波. 胃癌根治术中No.8淋巴结清扫的意义和技巧 [J]. 中国普外基础与临床杂志, 2007; 14(9)∶560.
14.	Kim AY, Kim HJ, Ha HK. Gastric cancer by multidetector row CT: preoperative staging [J]. Abdom Imaging, 2005; 30(4)∶465.
15.	Fukuya T, Honda H, Hayashi T, et al. Lymph-node metastases: efficacy for dectection with helical CT in patients with gastric cancer [J]. Radiology, 1995; 197(3)∶705.
16.	张晓鹏, 徐刚，孙应实，等. 胃癌组与正常组螺旋CT淋巴结检出率比较研究 [J]. 实用放射学杂志, 2002, 18(10)∶872.
17.	左藤修, 川端建二, 伊藤博敏, 等. 胃癌種植轉移的CT評價 [J]. 臨床放射線, 1999; 44(2)∶247.
18.	王舒宝，王俊. 胃癌复发与转移的有关问题及综合治疗 [J]. 中国普外基础与临床杂志, 2007; 13(1)∶9.
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1. 　李松年主编. 现代全身CT诊断学 [M]. 北京：中国医药科技出版社, 2001∶984～985.
2. 　冯琦, 庄治国, 许建荣. 多层螺旋CT判断胃癌胃壁浸润深度的价值 [J]. 中国医学影像技术, 2006; 22(2)∶257.
3. 　Chen CY, Hsu JS, Wu DC, et al. Gastric cancer: preoperative local staging with 3D multi-detector row CT——correlation with surgical and histopathologic results [J]. Radilogy, 2007; 242(2)∶472.
4. 　Yajima K, Kanda T, Ohashi M, et al. Clinical and diagnostic significance of preoperative computed tomography findings of ascites in patients with advanced gastric cancer [J]. Am J Surg, 2006; 192(2)∶185.
5. 　Hur J, Park MS, Lee JH, et al. Diagnostic accuracy of multidetector row computed tomography in T- and N staging of gastric cancer with histopathologic correlation [J]. J Comput Assist Tomogr, 2006; 30(3)∶372.
6. 　潘自来, 张欢, 张绍斌, 等. 多层螺旋CT胃癌术前TNM分期 [J]. 临床放射学杂志, 2002； 21(8)∶614.
7. 　Elia D, Zingarelli A, Palli D, et al. Hydro-dynamic CT preperative staging of gastric cancer: correlation with pathological finding: a prospective study of 107 cases [J]. Eur J Radiol, 1999； 10(12)∶1877.
8. 　Shiraga N, Kobayash S. Clinical application of multi-detector-row CT fox diagnosis of gastric cancer and degree of tumor invasion [J]. J Diagn Imaging, 2000; 3∶266.
9. 　Dong HL, Tac SS, Young TK. Spiral CT of the gastric carcinoma staging and enhancement pattern [J]. J Clin Imaging, 2001; 25∶32.
10. 　郭华, 高剑波, 杨学华, 等. 螺旋CT三期增强扫描对胃癌TNM分期的研究 [J]. 实用放射学杂志, 2003; 19(1)∶37.
11. 　Lee JH, Jeong YK, Kim DH, et al. Two-phase helical CT forde-tection of early gastric carcinoma: importance of the mucosal phase for analysis of the abnormal mucosal layer [J]. J Comput Assist Tomogr, 2000; 24(5)∶777.
12. 　Minami M, Kawauchi N, Ltai Y, et al. Gastric tumors: radioligic-pathologic correlation and accuracy of T staging of T staging with dynamic CT [J]. Radiology, 1992; 185(1)∶173.
13. 　胡建昆，陈志新，张波. 胃癌根治术中No.8淋巴结清扫的意义和技巧 [J]. 中国普外基础与临床杂志, 2007; 14(9)∶560.
14. 　Kim AY, Kim HJ, Ha HK. Gastric cancer by multidetector row CT: preoperative staging [J]. Abdom Imaging, 2005; 30(4)∶465.
15. 　Fukuya T, Honda H, Hayashi T, et al. Lymph-node metastases: efficacy for dectection with helical CT in patients with gastric cancer [J]. Radiology, 1995; 197(3)∶705.
16. 　张晓鹏, 徐刚，孙应实，等. 胃癌组与正常组螺旋CT淋巴结检出率比较研究 [J]. 实用放射学杂志, 2002, 18(10)∶872.
17. 　左藤修, 川端建二, 伊藤博敏, 等. 胃癌種植轉移的CT評價 [J]. 臨床放射線, 1999; 44(2)∶247.
18. 　王舒宝，王俊. 胃癌复发与转移的有关问题及综合治疗 [J]. 中国普外基础与临床杂志, 2007; 13(1)∶9.
19. 　李月春, 伍晓汀. 胃癌病理学与生物学特征的关系 [J]. 中国普外基础与临床杂志, 2007; 13(1)∶120.
20. 　Barry JD, Edwards P, Lewis WG, et al. Special interest radiology improves the perceived preoperative stage of gastric cancer [J]. Clin Radiol, 2002; 57(11)∶984.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of Multi-Slice Computer Tomography in Diagnosis and Preoperative TNM Staging of Gastric Carcinoma

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