| OBJECTIVE To investigate spiral CT(SCT) enhancement characteristics of gastric carcinoma,and the diagnostic value and preoperative staging of gastric carcinoma with dual-phase incremental spiral CT and drug-induced hypotonia and water-filling.METHODS 109 patients with historically proven advanced gastric carcinoma (AGC) were preoperatively imaged by spiral CT.Gastric distension and hypotonia were achieved by ingestion of up to 800~1000ml of water and intramuscular injection of 654-2.Cantrast scanning was performed after IV administration of nonionic contrast medium in arterial and portal veinous and/or equilibrium phase.Location,size and pathological type of the lesion was measured.we also studyed the imaging character of normal stomach wall and the lesion.Tumor infiltration,lymph-node involvement and organs metastasis were analyzed.The preoperative staging of cancer and resectabilitywere evaluated too.Finally,the results were correlated with histopathologic findings.RESULTS (1)The detection rate was 97.2% and diagnostic accuracy was 94.5%.(2)In all cases,location of the lesion defined by CT corresponded to the histological site.(3)The gartric wall thickening mass and multi-layered structure disapppearance etc were the features of AGC.(4)A multi-layered pattern of the gastric wall was appeared in 34.1% cases.(5)Most lesions almost showed marked enhencement in the portal veinous phase.(6)The accurally of T\ N and TNM preoperative staging was 86.7% 68.3% and 72.5% respectively. (7)The accuracy of resectability was 92.3%.CONCLUSIONS The diagnostic and staging accuracy of SCT in AGC is adequate.SCT is a useful guide for choosing between tumor resection and nonoperative treatment of patients.we therefore recommend SCT as the most available method for preoperative examination of advanceld gastric carcinoma.
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