Article Sidebar
Views PDF: 194
Imaging characteristics and the invasion, abdominal metastases of gastric cancer with MDCT
Main Article Content
Abstract
SUMMARY
Purposes: Describe imaging characteristics and assess value of MDCT in evaluating the invasion, abdominal metastase of gastric adenocarcinoma based on the 7 th AJCC guidelines.
Materials and methods: From 4/2014 to 3/2015, there are 32 consecutive patients with gastric adenocarcinoma were undergone 64-slide-CT. All of them were undergone operation with pathology after surgery.
Results: The average age is 63 years old, and male/ female=2/1. In 37.2% of cases gastric carcinoma is located on antrum. About macroscopic type, the forth type (linitis plastica) rates are highest 68.8%. The thickness of gastric cancer is pricipal 15-19 mm, all of cases heterogeneous enhancement. There are
17 cases invasion adjacent organs, in which tranverse colon is 8 cases and pancreas is 7 cases. Evaluating the value of diagnosis
peritoneal metastase between MDCT and surgical resection is appropriated with medial level Kappa = 0.53, the sensitivity is 75%, the specificity is 89.3%. The overall accuracy of T staging is 62.5% (T1 66.7%, T2-T3 69.2%, T4a 44.4%, and T4b 71.4%). Diagnosis lymph nodes metastasis based on the diameter has got the low valuation with p>0.05, based on the short axis diameter is < 8mm and ≥8mm has got p <0.05. About the shape of lymph nodes, based on irregular shape, peripheral enhancement and round shape to evaluate metastasis with p <0.05.
Conclusion: MDCT with multi-planar reformatted images has increased the accuracy of T and N staging, evaluated the invasion, abdominal metastase of gastric cancer on MDCT.
Article Details
References
1. Nguyễn Đình Hưởng (2012), “Vai trò của chụp cắt lớp vi tính trong chẩn đoán giai đoạn ung thư dạ dày có đối chiếu với phẫu thuật”, Ung thư học Việt Nam, số 4, tr.179-184.
2. Nguyễn Minh Khánh (2011), “Nghiên cứu giá trị của cắt lớp vi tính trong đánh giá xâm lấn và di căn ổ bụng ở bệnh nhân ung thư dạ dày”, Luận văn Thạc sĩ Y học, Đại học Huế, tr.36-71.
3. Feng X-y, Wang W, Luo G-y, Wu J, Zhou Z-w et al. (2013), “Comparison of Endoscopic Ultrasonography and Multislice Spiral Computed Tomography for the Preoperative Staging of Gastric Cancer-Results of a Single Institution Study of 610 Chinese Patients”, PloS ONE, 8(11), e78846.
4. Habermann CR (2004), “Preoperative Staging of gastric adenocarcinoma: Comparison of Helical CT and Endoscopic US”, Radiology, 230, pp.465-71.
5. Kim JW (2012), “Diagnosis performance of 64-section CT using CT gastrography in preoperative T staging of gastric cancer according to 7 th edition of AJCC cancer staging manual”, European Radiology, 22(3), pp.654-66.
6. Kim SJ (2009) “Peritoneal metastasis: detection with 16- or 64-detector row CT in patients undergoing surgery forr gastric cancer”, Radiology, 253(2), pp.407-15.
7. Lee IJ (2009), “Gastrointrestinal imaging: Helical CT evaluation of the preoperative staging of gastric cancer in the remnant stomach”, AJR, 192, pp.902-908.
8. Lee MH (2012), “Gastric cancer: Imaging and staging with MDCT based on the t th AJCC guidelines”, Abdom Imaging, 37(4), pp.531-40.
9. Pan Z (2010), “Determining gastric cancer resectability by dynamic MDCT”, Eur Radiol, 20(3), pp.613-20.
10. Park HS (2010), “Three-dimensional DCT for preoperative local staging of gastric cancer using gas and water distention methods: a retrospective cohort stydy”, AJR Am J Roentgenol, 195(6), pp.1316-23.
11. Yan et al. (2009), “Value of multidetectorrow computed tomograhy in the preoperative T and N staging of gastric carcinoma”, Journal of Surgical Oncology, 100, pp.205-214.