目的 探讨胃黏液腺癌(MGC)的MSCT特征。方法 回顾性分析77例经手术病理或内镜活检证实的进展期胃癌患者[(其中24例MGC,53例非黏液腺癌(NGC)]的MSCT相关征象,包括病灶厚度、平扫密度、强化方式、浆膜侵犯、淋巴结转移等。结果 黏液癌组胃壁平均厚度为(1.46±0.369) cm,高于非黏液癌组胃壁平均厚度(1.34±0.537) cm,两者间存在显著差异(P=0.02)。MGC平扫CT值为(27.00±5.28)HU,低于NGC(36.11±6.56)HU, 两者间存在差异(P〈0.000 1)。增强后门脉期,MGC以分层强化为主,占75.0%;NGC则以均匀强化为主,占60.4%;2种强化方式之间存在统计学差异(P〈0.000 1)。增强之后,动脉期及门脉期MGC强化程度均不及NGC(P〈0.000 1)。24例MGC患者中,5例可见增厚的低密度灶中斑点状或簇状钙化,NGC组中未见钙化。在肿瘤部位、淋巴结转移及浆膜侵犯方面,MGC与NGC组间没有明显差异。结论 胃MGC的MSCT表现具有一定的特征性。
Objective To analyze the MSCT features of mucinous gastric carcinoma(MGC). Methods A retrospective review of the MSCT features were performed in a series of 77 patients with hostologically verified advanced gastric cancer(24 MGCs and 53 NGCs) ,including thickness of tumor, attenuation of thickened gastric wall, contrast enhancement pattern, degree of enhancement, serous invasion and lymph node metastasis. Results Compared with NGC,the MGC tumors were thicker (1.46±0. 369 cm versus 1.34+0. 537 cm, P〈0.05) ,and with a lower attenuation (27.00±5.28 HU versus 36.11±6.56 HU,P〈0. 000 1). The most common contrast-en-hancement pattern in MGC was the layered type(75.0%) ,whereas the most common pattern in NGC was the homogeneous type(60.4% ). And NGC had a more evident enhancement(P〈0.0001). Five patients with MGC had military and punctuate calcification in their tumors. Tumor locations, serous invasion and lymph node metastasis were not correlated with operative pathologic classification. Con- clusion The MSCT features of MGC have certain useful characteristics.