PREOPERATIVE ASSESSMENT OF GASTRIC-CARCINOMA - VALUE OF 2-PHASE DYNAMIC CT WITH MECHANICAL IV INJECTION OF CONTRAST MATERIAL
PREOPERATIVE ASSESSMENT OF GASTRIC-CARCINOMA - VALUE OF 2-PHASE DYNAMIC CT WITH MECHANICAL IV INJECTION OF CONTRAST MATERIAL
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DOI：
10.2214/ajr.163.1.8010251
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发表时间：
1994-07-01
影响因子：
5
通讯作者：
LEE, CS
中科院分区：
文献类型：
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作者：
CHO, JS;KIM, JK;LEE, CS
客观的。本研究的目的是评估口服水后机械静脉推注对比剂进行两相动态 CT 在胃癌术前分期中的实用性。 对象和方法。我们对 52 例经病理证实的胃癌患者进行了增量动态 CT，对动态 CT 结果进行了前瞻性分析，并将其与手术和组织病理学结果相关联。使用动力注射器以 5 ml/sec 的流速静脉注射总共 150 ml 非离子造影剂 30 秒，并在推注开始后 30 秒（早期阶段）和 2 分钟（平衡阶段）获得两相图像。 结果。 41例进展期胃癌动态CT早期表现为中度至显着不均匀强化，平衡期表现为整个病灶均匀强化。动态CT正确检出9例早期胃癌中的5例（56%）和43例晚期胃癌中的41例（95%）原发肿瘤，胃癌总体检出率为88%（52例中的46例）。根据TNM分期的动态CT确定肿瘤浸润深度、浆膜浸润程度和区域淋巴结转移的准确率分别为65%（52例中的34例）、83%（46例中的38例）和70%（46例中的32例）。结论。我们的研究结果表明，在胃癌术前分期中，与传统 CT 相比，口服水后机械静脉注射造影剂的两相增量动态 CT 提高了 CT 的诊断准确性。
OBJECTIVE. The purpose of this study was to evaluate the utility of two-phase dynamic CT performed with mechanical IV injection of a bolus of contrast medium after oral intake of water in the preoperative staging of gastric cancers.SUBJECTS AND METHODS. We performed incremental dynamic CT in 52 patients with pathologically proved gastric cancers, Dynamic CT findings were prospectively analyzed and correlated with surgical and histopathologic findings. A total of 150 mi of nonionic contrast medium was administered IV with a power injector at a flow rate of 5 ml/sec for 30 sec, and two-phase images were obtained at 30 sec (early phase) and 2 min (equilibrium phase) after the start of bolus injection.RESULTS. Forty-one advanced gastric carcinomas showed a moderate to marked degree of heterogeneous enhancement in the early phase and homogeneous enhancement of the entire lesion in the equilibrium phase of dynamic CT. The primary tumors were correctly detected with dynamic CT in five (56%) of the nine early gastric cancers and in 41 (95%) of the 43 advanced gastric cancers, The overall detection rate of gastric cancers was 88% (46 of 52 cases). The accuracies of dynamic CT according to TNM staging in determining the depth of tumor invasion, the degree of serosal invasion, and regional lymph node metastasis were 65% (34 of 52 cases), 83% (38 of 46 cases), and 70% (32 of 46 cases), respectively.CONCLUSION. Our findings show that two-phase incremental dynamic CT with mechanical IV injection of a bolus of contrast medium after oral intake of water improves the diagnostic accuracy of CT over that provided by conventional CT in the preoperative staging of gastric cancers.