| Objective: To determine the regional lymph nodes metastasis of gastriccancer with spectral CT imaging, discuss the clinical value of CT inevaluating the lymph nodes metastasis of gastric cancer throughcomparison with clinicopathological results, further improve the accuracyof preoperative diagnosis and provide the more valuable informationwhich will be useful for choosing a reasonable surgical treatment.Object: During October2010to February2011,40patients (28malesand16females) who all had gastric cancer confirmed by gastroscopy,were selected and underwent with dual-phase enhanced CT scan(Discovery CT750HDCT, GE-Healthcare) using GSI mode in arterialphase.Materials and Methods:20mg654-2were injected intramuscularly. Tenminutes later, ask the patient to drink800-1000ml water and do thebreath training. Injection of The contrast agent (Omnipaque300,88ml)was implemented in the median cubital vein. After30s for arterial phaseand60s for venous phase,10ml saline at an injection rate of3.0ml/swas injected. Scan range: for arterial phase CT, it was from the loweresophagus to the lower pole renal level, and included the entire stomach;for venous phase it was from the top of the diaphragm to the pelvis,namely the whole abdomen. The raw data was transmitted to the adw4.5 workstation and processed. CT values of the regional lymph nodes wereobtained. The ones, whose CT values of arterial phase are no less than50Hu, are considered to have the lymph node metastasis; if the ratio of shortdiameter and long diameter of regional lymph nodes is no less than0.7,the ones are considered to have the lymph node metastasis. The twomethods are the traditional ways to determine the lymph node metastasis.In our studies, spectral HU curves of regional lymph nodes and stomachlesions were obtained with GSI software. If the two curves substantiallyoverlap, lymph node metastasis has occurred. According to postoperativepathology, the regional lymph nodes of gastric cancer were evaluated. Ascompared to the traditional methods, the evaluation results of our CTmethod were more consisted with pathological results.Results: In contrast to the pathology, the significant differences werefound for the traditional methods (P=0.025and P=0.008, P<0.05). Whileour CT method in this study had no significant difference (P=0.317andP>0.05).Conclusion: Spectral HU curves of regional lymph nodes and stomachlesions can be obtained with GSI software during arterial phase. Throughcomparison of the two curves, the regional lymph nodes metastasis can beverified more accurately than, the traditional methods. Therefore, it hasmuch potential for clinical application. |
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