| Object: Analysis images around the gastric antrum cancer infiltration of threephase enhanced scanning and multiplanar reconstruction (MPR) technique of64-slicespiral CT (64-slice spiral computed tomography,64SCT) and compared withoperation and pathology.To explore the application value of it, and provide reference forclinical.Methods:87cases of gastric antrum cancer confirmed by surgery and pathologywere enrolled in this study, including47male and40female aging31-87years old withan average age of54.3years. All data were collected from October,2010to November,2012in the first affiliated hospital of Henan Science and Technology University.patients were fasted for8-12h before CT examination, using the United States GE64-slice spiral CT (LightSpeed VCT). The scan Protocols included both non-enhancedand contrast-enhanced scanning.The87patients were examined by MSCT and inseven days before opeatation,and the MSCT results compared to the results of operationand pathology. it．All the CT images werc analyzed by2senior radiologists withoutinformation about gastroscopic surgical and histological results.consensus were reachedthrough discussion when there were disagreement. The data were analyzed by SPSS19.0for windowswith count data by X2test and consistency test by Kappa test.Results:(1)Accuracy of MSCT on invasion depth of gastric antrum cancer (thetotal accuracy of T staging) was79.31%(69/87), and was associated with the operationand pathology (P<0.05).Good coincidence between T2and T4invasion,the Kappavalues were0.628and0.784respectively. The consistency of phase T3was poor, andthe Kappa value was0.416.(2)The MSCT results showed no significant differencebetween enhancement degree of the gastric antrum cancer and depth of invasion, therewere significant difference between the size,thickness and the depth of invasion(P<0.05). In portal venous phase,enhancement degree of poorly differentiated gastricantrum carcinoma and high differentiation was statistically significant (P<0.05).(3)The MSCT results showed that size, thickness, enhanced features of gastric antrum cancerand operation pathology were statistically significant (P<0.05)(4)MSCT results showedthat gastric antrum carcinoma with invasion of adjacent organs (T4) was poorlydifferentiated carcinoma.(5)The MSCT results showed high accuracy of gastriccarcinoma infiltrating the liver, colon, duodenal, Gallbladder, but accuracy of pancreaticwas slightly lower,and sensitivity is the lowest.(6)The MSCT reslults showed enhancedfeature of gastric antrum cancer of diffuse type was more poorly differentiatedcarcinoma, and tumor invasion depth was deeper,and probability of infiltratingsurrounding organs was higher. Enhanced feature of gastric antrum cancer of intestinaltype was medium or high differentiation carcinoma, and the invasive depth is lower,andthe probability of infiltrating surrounding organs was lower.(7)Most of Gastric antrumcancer in the portal venous phase were significantly enhanced.63.2%(55/87) of gastricantrum carcinoma in the portal vein phase were significantly enhanced,31%(27/87) inthe balance period,5.8%(5/87) in the arterial phase.Conclusion:(1)MSCT results showed infiltration of gastric antrum cancer wascorrelated with postoperative pathologic staging．(2)MSCT images of gastric antrumcancer(size, thickness, depth of invasion) were correlated with operation and pathology.MSCT results showed that there was correlated between gastric antrum cancer size,thickness and depth of infiltration.(3)Most of gastric antrum cancer in the portal venousphase were significantly enhanced. Enhanced features and the depth of tumor invasion(T staging operation pathology) were correlated,and enhanced features and operationpathological grade(high/middle and low) were not correlated.(4)Three enhanced scanof MSCT and MPR reconstruction in gastric carcinoma have important guidingsignificance to the clinical treatment, and has important value for the correct evaluationand monitoring prognosis around invasion of gastric antrum cancer. |
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