• 四川大學(xué)華西醫(yī)院放射科(成都610041);

【摘要】目的 研究胃癌侵犯胃裸區(qū)(gastric bare area, GBA)的CT表現(xiàn)和解剖基礎(chǔ),探討多排螺旋CT在診斷中的價(jià)值。
方法 回顧性分析196例連續(xù)性胃癌病例的CT資料,其中GBA受累56例(28.6%),按解剖部位分為近側(cè)胃癌(proximal gastric cancer, PGC)組和遠(yuǎn)側(cè)胃癌(distal gastric cancer, DGC)組。觀察胃癌侵犯GBA的CT表現(xiàn)特征,比較PGC組和DGC組胃癌侵犯GBA的出現(xiàn)率差異。
結(jié)果 56例中,有46例表現(xiàn)為GBA內(nèi)軟組織腫塊,10例表現(xiàn)為結(jié)節(jié)狀淋巴結(jié)。胃癌侵犯GBA病例的CT征象有: GBA增寬,胃壁與膈肌之間的薄層脂肪間隙中斷或消失; GBA內(nèi)可見(jiàn)不均勻強(qiáng)化的軟組織密度腫塊或類(lèi)圓形淋巴結(jié); 左膈腳及胃膈韌帶不規(guī)則增厚并與腫瘤分界不清; 膈下腹膜后間隙淋巴結(jié)腫大。PGC組中,胃癌侵犯GBA的出現(xiàn)率為70.0%(42/60),而在DGC組僅為10.3%(14/136),兩者間差異有顯著性意義(P=0.025)。
結(jié)論 PGC侵犯GBA的出現(xiàn)率高于DGC。胃癌侵犯GBA有一定的CT表現(xiàn)特征。多排螺旋CT在術(shù)前評(píng)價(jià)GBA受侵和淋巴結(jié)轉(zhuǎn)移方面具有重要價(jià)值。

引用本文: 伍兵,閔鵬秋,宋彬,劉榮波,盧春燕,朱捷. 多排螺旋CT在診斷胃癌侵犯胃裸區(qū)中的價(jià)值. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005, 12(4): 411-414. doi: 復(fù)制

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  2. 2. Stassen LP, Bosman FT, Siersema PD, et al. Recurrence and survival after resection of adenocarcinoma of the gastric cardia. Rotterdam Esophageal Tumor Study Group [J]. Dis Esophagus, 2000; 13(1)∶32.
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  4. 4. Tonelli P. Gastric carcinomas of the “bare area”. Their anatomosurgical definition and proposal of an en bloc total gastrectomy [J]. Ann Ital Chir, 1999; 70(3)∶405.
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