CAJ | 학술논문

目的：分析小网膜受胃癌侵犯的 CT 表现及其对胃癌病变向外蔓延扩散的影响。方法回顾性探讨48例胃癌累及小网膜病例的 CT 图像,包括胃癌病灶的部位、形态,小网膜受累的 CT 征象,胃癌病变向外扩散蔓延的情况,分析伴随腹水的情况。结果胃癌累及小网膜的 CT 表现包括：①直接浸润(35.4%,17/48),主要表现为小网膜脂肪密度增高、肿块形成,其中有2例蔓延累及肝脏(4.2%,2/48)；②种植转移(25.0%,12/48),表现为污迹状(11例)和饼状改变(1例)；③淋巴结转移(64.6%,31/48),包括淋巴结增大增多(27例)和囊样灶(4例)。腹腔积液11例,其中3例可见网膜囊积液,小网膜参与网膜囊构成,将网膜囊积液与大腹腔积液隔开,统计分析提示种植转移与伴随腹水的关系较为密切。结论胃癌可以多种方式侵犯小网膜,其 CT 扫描有多种表现。小网膜对胃癌病灶向外浸润扩散,起着一定的引导作用；对胃癌产生的腹水,起着一定的分隔作用。
목적：분석소망막수위암침범적 CT 표현급기대위암병변향외만연확산적영향。방법회고성탐토48례위암루급소망막병례적 CT 도상,포괄위암병조적부위、형태,소망막수루적 CT 정상,위암병변향외확산만연적정황,분석반수복수적정황。결과위암루급소망막적 CT 표현포괄：①직접침윤(35.4%,17/48),주요표현위소망막지방밀도증고、종괴형성,기중유2례만연루급간장(4.2%,2/48)；②충식전이(25.0%,12/48),표현위오적상(11례)화병상개변(1례)；③림파결전이(64.6%,31/48),포괄림파결증대증다(27례)화낭양조(4례)。복강적액11례,기중3례가견망막낭적액,소망막삼여망막낭구성,장망막낭적액여대복강적액격개,통계분석제시충식전이여반수복수적관계교위밀절。결론위암가이다충방식침범소망막,기 CT 소묘유다충표현。소망막대위암병조향외침윤확산,기착일정적인도작용；대위암산생적복수,기착일정적분격작용。
Objective To investigate the CT manifestations of gastric carcinoma invasion to lesser omentum and to assess the im-pact of lesser omentum on the spreading of gastric carcinoma.Methods We retrospectively reviewed CT findings in 48 patients with gastric carcinoma and lesser omentum involved for primary tumor and the lesser omentum abnormalities.The influence of lesser o-mentum on the extension of gastric carcinoma as well as the accompanied ascites were also analyzed.Results CT manifestations of lesser omentum involvement in gastric carcinoma included the following items:① direct infiltration (35.4%,1 7/48),which was mainly shown as increased density of fatty tissue and the development of mass within the lesser omentum,including spreading into the liver through the lesser omentum directly in two cases;② omental seeding (25.0%,12/48),including "smudged" appearance (1 1 cases)and "omental caking" (1 case);③ metastasis of lymph nodes (64.6%,31/48),including enlargement and increase of lymph nodes (27 cases)and cystic mass (4 cases).Ascites was found in 1 1 patients and fluid collection in the lesser sac was shown in 3 of these 1 1 patients.The lesser omentum forms the anterior wall of the lesser sac and separates the fluid collection in the lesser sac from the ascites in the greater peritoneal cavity.Ascites was associated with the omental seeding statistically.Conclusion CT scan is helpful for detecting lesser omentum invasion by gastric carcinoma.The imaging features consist of mass sign,enlargement of lymph nodes,"smudged" and"caking"appearance,and so on.Lesser omentum may also play a certain role in both the extension of gastric carcinoma and the compartmentalization of ascites due to gastric carcinoma.