Correlation Analysis Between Multi-row Spiral Ct Characters Of Gastric Carcinoma And Staging And Histological Differentiation

Part one The analysis between gastric carcinoma multi-rowspiral CT characters and pathologyObject: To review and analysis features of gastric cancer by64-row spiral CT, andevaluate correlation and TN staging accuracy of gastric cancer by CT.Materials and Methods: To collect503gastric cancer patients who underwent64slice CT examinations by PACS, all cases were confirmed by operation and pathology.Two senior radiologists reconstructed and observated all images selected in ADW4.3workstation. The collected data included the lesion length, thickness, location, grossmorphology, lesion enhancement degree, serous sign, depth of invasion and lymph node.The significant level value is0.05, P <0.05considered statistically significant.Results: The average length and thickness of gastric lesions were57.31±22.69mm,12.64±5.21mm respectively. The length and thickness of gastric cancer with pathologicalTN stage had significant correlation (P <0.01). The predilection sites of gastric cancer areantrum and gastric cardia. Fungating type gastric cancer is the most common type. Thelocation of gastric cancer and T staging of gastric cancer had no correlation. The locationof gastric cancer and gastric cancer N staging was significantly correlated (P=0.004).Gross morphology and pathology TN staging of gastric cancer had no correlation (P>0.05). Precontrast and three phase enhanced lesions showed significant difference(P=0.000). Univariate ANOVA analysis showed that gastric cancer pathological TNstaging was no significant difference in plain and arterial phase, there (P>0.05), venousphase and delayed phase difference was significant (P=0). Perigastric fat fuzzy features inT3are the most common. T1,2periods without serosal high enhancement sign, it is86.96%in T4. The serosa features was correlated with the T staging of gastric cancer (P <0.05).64slice spiral CT in the diagnosis of T1the sensitivity，specificity and accuracy were 52.17%,99.03%and90.46%. T2sensitivity, specificity and accuracy were56.25%,93.62%and88.87%. T3sensitivity, specificity and accuracy were95.11%,76.02%and87.67%. T4sensitivity, specificity and accuracy were100%,98.27%and98.41%. Thediagnostic total accuracy of gastric cancer CT Tstaging is82.70%.Lymph node short diameter≥6mm for sensitivity, specificity and accuracy were71.14%,36.10%and56.86%; sensitivity, specificity and accuracy of diagnostic criteria(≥8mm) were90.72%,28.20%and57.65%; sensitivity, specificity and accuracy ofdiagnostic criteria (≥10mm) were93.17%,32.28%and62.43%. In different shortdiameter standard of lymph node CT-N staging accuracy showed no statistical significancewith U test (P>0.05). CT value of lymph node precontrast and three phase enhanced hadno significant difference at different T stages (P>0.05).Conclusion: There has a statistical correlation between64row spiral CT features andTN staging of gastric cancer.64row spiral CT can accurately judge the gastric cancerinvasion depth, lymph node metastasis and has high accuracy in TN staging of gastriccancer. There is no statistical significant in judging N sating by differet standard withminor axis of lymph node.Part two The primary investigation different differentiationgastric cancer by multi-rows spiral CTObject: To explore CT imaging features of the different differentiation gastric cancerby study correlation of64-slice spiral CT features of gastric cancer and varying degrees ofdifferentiation pathology.Materials and Methods:422gastric cancer cases that confirmed by operation andpathology were collected by PACS. All patients had definite pathologic differentiationgrade. Preparation before examination, scanning conditions, reconstruction method andanalysis method is the same with the first part.Results: The average length and thickness of gastric cancer were56.14±20.78mm,12.37±5.16mm respectively. Gastric lesion length was statistically significant in differentdifferentiation (F=6.482, P <0.001). The thickness of gastric lesions in differentdifferentiation is not statistical significance (F=1.887, P=0.131). Antrum is the commonposition of gastric cancer, not high differentiation adenocarcinoma involving the whole stomach, poorly differentiated adenocarcinoma accounted for52.94%. Fungating typegastric cancer accounted for79.86%, in low differentiated adenocarcinoma andadenocarcinoma accounted for82.49%, diffuse type gastric cancer is not welldifferentiated adenocarcinoma. Different differentiated gastric cancer CT values had nosignificant difference in the plain and the arterial phase (P>0.05), in the presence ofsignificant difference in venous phase and delayed phase (P <0.01).It has not highdifferentiated adenocarcinoma in hyperattenuating serosa cases, low differentiationadenocarcinoma accounted for52.94%. CT-T staging of gastric cancer was42cases of T1stage,56cases of T2stage,288cases of T3,36cases of T4. High differentiationadenocarcinoma accounted for only1.74%in T3,no high differentiation adenocarcinoma inT4staging. There is no significant between different types of gastric cancer and three shortdiameter standards CT-N staging.In the differentiation group, the difference of CT valuesin lymph node plain scan, arterial phase, venous phase and delayed phase was notsignificant (P>0.05).Conclusion: There is correlation between gastric cancer CT features (including lesionlength, thick and enhancement) and differentiation degree. Hyperattenuating serosa signpredicts low differentiated adenocarcinoma. There is no statistical significant betweenlymph node CT value, enhancement and gastric cancer differentiation degree.