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Analysis and differentiation of CT signs in gastric wall thickness diseases
LI Jian ding , QIAO Ying，ZHANG hua, ZHANG Rui Ping, E ling ning
[Abstract]
Objective To study CT characteristics of gastric wall thickness diseases.
Methods The CT scan datum of 79 patients pathologically and synthetic clinic diagnosis proved gastric wall thickness diseases were analyzed retrospectively.
Results In 79 cases, thickened gastric wall patters were evaluated under 6 forms of strip（21 cases）,ulcer(11cases),lump(diameter≥3cm,17 cases), nodiform(diameter＜3cm,11 cases), mixed type(15 cases), coralline(4 cases).There are some features respectively in benign and malignant gastric wall thickness. Preoperative accuracy rate was 100%(79/79)、 84%(66/79)、81%(64/79) respectively at location ,benign or malignant,and histology type judgement.
Conclusion CT appearances of gastric wall thickness diseases is important and valuable to diagnose and differentiate.
[Key words]Gastric disease;Gasrtric wall thickness; Tomography, X-ray computed
胃壁增厚是多数胃部病变主要的甚至是唯一的CT表现，其形态学表现对病变的诊断有重要的作用[1]。本文收集了1999年-2005年我院79例胃壁增厚性病变,分析其CT特征,旨在提高CT对壁增厚性病变诊断和鉴别水平。
1资料与方法
1.1一般资料： 79例中,男52例,女27例,年龄35-87（53.3±11）岁,临床主要症状有腹痛、腹胀、纳差、消瘦、出血等。病例包括进展期胃癌41例，胃淋巴瘤8例，胃平滑肌肉瘤4例；平滑肌瘤3例，脂肪瘤1例；胃间质瘤7例(良性2例)；慢性胃炎2例，胃溃疡4例，胃粘膜巨肥厚症3例；胃底静脉曲张6例。胃底静脉曲张例经临床、造影、胃镜综合诊断证实，余均经手术或胃镜病理证实。
1.2检查方法：采用SOMATOM PLUS 4型及EMOTION型全身螺旋CT机，空腹10-12小时，于检查前15分钟内口服温开水800-1200ml，其中43例肌注654-2 20mg。扫描层厚5mm-8mm，螺距1.5-1。22例行平扫，余行平扫加双或三期增强扫描。造影剂为非离子型Utravist（300mgI/ml），量1.5ml/kg，速率3.0ml-3.5ml/s。
1.3胃臂增厚的确定：测量胃底体部胃壁厚度>3mm、胃窦部和胃食管连接区>5mm为基础指标，同时排除生理性的胃壁增厚。
1.4 CT图像分析：与手术病理及临床资料对照，回顾性分析上述病变CT表现。重点观察胃壁增厚形态，以及良恶性对比。
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