| Aims: To retrospectively analyze the CT features among gastric cancer, gastric lymphoma and malignant stromal tumor to probe into characteristic CT signs of the three tumors and evaluate the application value of CT in gastric malignant tumor.Methods: 52 patients with gastric malignancies underwent preoperative CT plain scan and biphasic contrast enhancement. Referring to the histopathological results, to observe the CT images including tumor location, appearance, mucous membrane, gastric wall, enhancement manifestation, lymphadenectasis, spleen enlargement and involvement of other organs, and to make statistical analysis for imaging features of these tumors byχ2 testing.Results: 52 cases of malignant tumor of stomach including 20 cases of gastric cancer, 16 cases of gastric lymphoma and 16 cases of malignant gastric stromal tumors were pathologically confirmed. The CT findings are as follows: involved gastric mucosal surface was found in all the gastric cancer patients, the positive rate was higher than lymphoma and malignant stromal tumor (P <0.05). To make a pairwise comparison by the reference whether the extensive range is lager or less than 50% of the stomach circumference, it was statistically significant only between lymphoma and stromal tumor (P <0.05). To make a pairwise comparison between the three by the reference of the gastric wall thickness of 2cm, gastric cancer and lymphoma, gastric cancer and stromal tumor were both statistically significant (P <0.05). "White line sign "can be seen in the 15 cases (75.0%) of gastric cancer patients , but not be seen in all the gastric lymphoma and malignant stromal tumor. 13 cases (65.0%) of gastric cancer and 11 cases (68.75%) of malignant stromal tumor were significantly enhanced, 16 cases (100%) of gastric lymphoma showed no obvious enhancement. 13 cases (65.0%) of gastric cancer turned up progressive enhancement,all the gastric lymphoma and malignant stromal tumor appeared no progressive enhancement. The positive rate of enlarged lymph nodes in gastric cancer (65.0%) and lymphoma (87.5%) were higher than stromal tumor (6.25%) (P <0.05). The positive rate of splenomegaly among the pairwise comparisons between the three was not statistically significant (P>0.05).Conclusions: The CT manifestations of gastric malignant tumors have different characteristics. Gastric cancer more assumes thickened gasrtic wall near the stomach cavity with mucosal ulcer; the inner surface of gastric wall shows obvious enhancement and often penformances progressive enhancement; lymphadenectasis usually appears. Gastric lymphoma mostly performances diffusively thickness through the whole gastric wall with intact mucous membrane; it often has no or mild homogeneous enhancement; it is always accompanied by lymphadenectasis. Malignant stromal tumor usually manifests the form of outer-cavity mass with obviously non-homogeneous enhancement; it scarcely transfer through lymph node metastasis. Spiral CT shows great value in diagnosis and differentiation of gastric malignant tumors. |
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