CAJ | 학술논문

目的：探讨进展期胃癌病灶强化程度及强化方式与组织学分型的关系。方法进展期胃癌共121例，术前行64层螺旋CT三期增强扫描，应用轴位图像结合VR、MPR和MIP重建，研究CT图像上病灶的强化程度及强化方式，并将结果与术后病理所示胃癌组织学分型比较分析。结果病灶强化程度与病理类型之间的关系为：腺癌中度强化为主（ n ＝57，61．3％），黏液腺癌轻度强化为主（ n ＝7，46．7％），印戒细胞癌明显强化为主（ n ＝8，61．5％）。病灶强化方式主要为：腺癌均匀强化（ n ＝58，62．4％），黏液腺癌内层强化明显（n＝13，86．7％），印戒细胞癌内层强化明显（n＝7，58．3％）。结论进展期胃癌MSCT三期增强扫描病灶强化程度与病灶强化方式与胃癌组织学分型密切相关，在病理诊断前正确识别各类型的胃癌，将有助于治疗方案的制定和优化，对于观察肿瘤的生物学行为以及治疗疗效的判定具有重要意义。
목적：탐토진전기위암병조강화정도급강화방식여조직학분형적관계。방법진전기위암공121례，술전행64층라선CT삼기증강소묘，응용축위도상결합VR、MPR화MIP중건，연구CT도상상병조적강화정도급강화방식，병장결과여술후병리소시위암조직학분형비교분석。결과병조강화정도여병리류형지간적관계위：선암중도강화위주（ n ＝57，61．3％），점액선암경도강화위주（ n ＝7，46．7％），인계세포암명현강화위주（ n ＝8，61．5％）。병조강화방식주요위：선암균균강화（ n ＝58，62．4％），점액선암내층강화명현（n＝13，86．7％），인계세포암내층강화명현（n＝7，58．3％）。결론진전기위암MSCT삼기증강소묘병조강화정도여병조강화방식여위암조직학분형밀절상관，재병리진단전정학식별각류형적위암，장유조우치료방안적제정화우화，대우관찰종류적생물학행위이급치료료효적판정구유중요의의。
Objective To investigate the correlation of extent and pattern of computed tomography ( CT) enhancement of tumor lesions and histological types in advanced gastric carcinoma .Methods A total of 121 ca-ses of advanced gastric carcinoma were included in this study .Tri-phase enchanced 64-slice spiral CT scan-ning was performed before operation for every patient .We judged the extent lesions′of and pattern of enhance-ment using axial images combined with reconstruction of VR ,MPR and MIP.Then the radiographic result of every subject was compared with its corresponding postoperative histological type after operation .Results In the pres-ent study,the correlation of extent of CT enhancement of tumor lesions and histological types were as follows :ade-nocarcinoma patients were mostly with moderate enhancement ( n=57,61.3%),mucinous adenocarcinoma pa-tients were mostly with mild enhancement (n=7,46.7%).While obvious enhancement were mostly observed in patients with signet ring cell carcinoma(n=8,61.5%).The correlation of pattern of CT enhancement of tumor lesions and histological types were as follows:adenocarcinoma patients were mostly with well -distributed en-hancement(n=58,62.4%),while endothecium obvious enhancement were mostly seen in patients with mucinous adenocarcinoma(n=13,86.7%)and signet ring cell carcinoma (n=7,58.3%).Conclusions There are signif-icant correlation between advanced gastric carcinoma′s tri-phases enhancement characteristics with 64-slice spiral CT and its histological types .Judging histological type using 64-slice spiral CT before operation is useful for formulating and optimizing the therapeutic regimen for gastric cancer patients ,and it is significant for observing the tumors′biological behavior and judging the curative effect .