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Value of 64-slice Spiral CT in Evaluating Staging and Blood Supply of the Gastric Cancer

Author: SunZuo
Tutor: TianJianMing
School: Second Military Medical University
Course: Medical Imaging and Nuclear Medicine
Keywords: 64-slice CT gastric thickness MPR gastric cancer TNM 64-slice CT angiography blood supply VR MIP Gastric Stromal Tumors 64-slice spiral CT
CLC: R735.2
Type: Master's thesis
Year: 2008
Downloads: 85
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Abstract

Objectives:To study the detection and preoperative staging of gastric cancer with 64-slice spiral CT,compared with surgical findings and pathology.Application the 64-MSCTA to demonstrate the blood vessel around the stomach and the blood supply of the gastric cancer.PartⅠThe study of the gastric thicknessObjectives:To determine the value of 64-slice CT scanning and 3-D imaging in the gastric subaera and thickness of gastric wall.Materials and Methods:40 normal volunteer underwent 64-slice spiral CT between April 2007 and February 2008.The volunteer received water of 1000ml orally and muscle injection of 654-2(20mg) for controlling the vermicular motion of stomach before CT scanning.All scans were obtained with 64-slice spiral CT(SOMATOM Sensation 64,Siemens Medical System).Image acquisition and reconstruction parameters for CT scanner was as follows:tube voltage of 120Kv,tube current of 160-180mAs,section thickness of 64×0.6mm,per rotation times of 0.5s and FOV of 370mm-400mm.Images of MPR were obtained by using slice thickness of 6mm and reconstruction intervals of 0.6-1.5mm.All volunteer underwent contrast-enhanced CT scanning with receiving 80ml of nonionic contrast medium(Ultravist 370) administered intravenously and at a rate of 4.0-5.0ml/sec.Results:Stomach could be divided into four subareas:cardia,stomach body,stomach fundus,and pylorus.The thickness of gastric wall was measured on the images of CT. There thickness was 4.12±0.32mm,2.25±0.18mm,2.23±0.14mm,3.65±0.23mm at cardia, stomach body,stomach fundus,and pylorus,respectively.PartⅡComparative study of the 64-slice CT staging of gastric cancer and histopathological stagingObjectives:To evaluate the diagnostic value of 64-slice spiral CT in the TNM staging of gastric cancer.Materials and Methods:60 gastric cancer patients in Changhai hospital underwent 64-slice spiral CT between April 2007-February 2008.Image acquisition and reconstruction parameters for CT scanner was as follows:tube voltage of 120Kv,tube current of 160-180mAs,section thickness of 64×0.6mm,per rotation times of 0.5s and FOV of 370mm-400mm.All patients underwent contrast-enhanced CT scanning with receiving 80ml of nonionic contrast medium(Ultravist 370) administered intravenously and at a rate of 4.0-5.0ml/sec.Images of MPR were obtained by using slice thickness of 6mm and reconstruction intervals of 0.6-1.5mm.Results:Application the MPR imagine technique,the accuracy of T2 and T3 staging were 91.7%and 87%.MPR imagine technique has not effect the accuracy of T1 and T2.Lymph node was larger than 5mm as the metastasis-positive nodes.Sensitivity is 76%,specificity is 67.2%,positive predictive value is 90.3%.The accuracy of M staging is respetively 70%,90%.The M staging was in good accordance with pathological findings(X~2 =5.79,P＜0.025).Conclusion:The 64-slice CT can promote the accuracy of gastric cancer staging. Preoperative staging of gastric cancer may have a positive effect on clinical therapy.PartⅢ:Study of blood supply of gastric cancerObjectives:To discuss the value of the 64-MSCTA in evaluation of normal blood vessels around the stomach and the blood supply of the gastric cancer.Materials and Methods:40 gastric cancer patients underwent 64-slice spiral CT between April 2007 and February 2008 in Changhai hospital.All scans were obtained with 64-slice spiral CT(SOMATOM Sensation 64,Siemens Medical System).Image acquisition and reconstruction parameters for CT scanner was as follows:tube voltage of 120Kv,tube current of 160-180mAs,section thickness of 64×0.6mm,per rotation times of 0.5s and FOV of 370mm-400mm.All patients underwent contrast-enhanced CT scanning with receiving 80ml of nonionic contrast medium(Ultravist 370) administered intravenously and at a rate of 5.0ml/sec.Application 64-slice CT angiography demonstrate sufficiently the blood vessels around the stomach and the blood supply of the tumor.Results:Celiac artery,left gastric artery,right gastric artery and right gastroepiploic artery can clearly be showed.We can find the blood supply of the gastric cancer.MIP technique is superior to VR in the show of small blood vessel,but VR can show the relationship between the stomach and blood vessel.The vessels which had leipo—interspace and encased partly or completely with the tumors demonstrated regular vessel wall and non-stenotic lumens.Six blood vessels were destroyed by the tumors.Gastric malignancies of patients were supplied by gastric arteries basically.Conclusion:64-slice CT angiography demonstrate sufficiently the blood vessels around the stomach and the blood supply of the tumor.We can see the relationships between the blood vessels and tumor any angle.PartⅣ:CT Diagnosis of Gastric Stromal TumorsObjectives:To investigate the CT features of gastric stromal tumors(GST)and its diagnostic value.Materials and Methods:same to partⅡResults:Among 10 cases with GST,there were submucosa in 2 cases,intersarcoparies in 6 cases,subserosa in 2 cases.6 cases were malignant,2 cases were benign,2 cases were not be sure malignant or benign.10 cases showed as exogenous or endogenous mass with diameter of 2-14cm,4 cases were 2-5cm,and 6 cases were 5-14cm.The malignant tumors were cystic-solid with inhomogenous attenuation,the solid potion of tumors enhanced slightly and moderately.There were central hypodeasity areas in the masses as well as peripheral enhancement.Conclusion:CT findings of GST has some features which is helpful for locating the tumor and making sure GST is benigh or malignant.So CT examination has important clinical value.

Value of 64-slice Spiral CT in Evaluating Staging and Blood Supply of the Gastric Cancer

Abstract

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