胃癌侵犯胃裸区的CT 表现及其解剖病理基础

目的 探讨胃癌侵犯胃裸区（GBA）的CT表现和解剖病理基础。方法 回顾性分析110例近侧胃癌（PGC）连续性病例的CT资料，其中外科手术和病理证实GBA受到肿瘤侵犯46例。观察胃癌侵犯GBA的CT表现特征，分析CT征象的解剖病理基础。结果46例中有38例表现为GBA内软组织肿块，8例表现为结节状淋巴结。胃癌侵犯GBA病例的CT征象有：（1）GBA增宽，胃壁与膈肌之司的薄层脂肪司隙中断或消失（36例）。（2）GBA内可见不均匀强化的软组织密度肿块（38例）或类圆形淋巴结（8例）。（3）左膈脚及胃膈韧带不规则增厚并与肿瘤分界不清（25例）。（4）膈下腹膜后司隙其他转移性淋巴结肿大（3例）。结论 胃癌侵犯GBA有定的CT表现特征。解剖位置和淋巴引流是PGC侵犯GBA的重要原因，并且可能与PGC的预后较差有关。

Gastric bare area involvement by gastric carcinoma: CT features and anatomic-pathological bases

Objective To investigate the CT features of gastric bare area(GBA) involvement by gastric carcinoma and their anatomic-pathological bases.Methods CT images of 110 consecutive proximal gastric carcinoma(PGC) cases were retrospectively studied. Of them, 46 cases of GBA involvement were confirmed by surgery and pathology. CT features of GBA involvement by gastric carcinoma and their anatomic-pathological bases were analyzed. Results The lesion appeared as mass in bare area in 38 cases and as metastatic lymphadenopathy in 8 cases.CT features of GBA involvement included:(1)Gastric bare area was widened.The thin fat strip between gastric wall and diaphragm obscured,or even disappeared (36 cases) .(2)Soft tissue density mass with heterogeneous enhancement(38 cases) or round lymph nodes(8 cases) was seen in GBA. (3) Left diaphragmatic crus or gastrophrenic ligament irregularly thickening was presented and could not be separated from mass tissue(25 cases).(4) Other metastatic lymph nodes located in subphrenic extra-peritoneal space might also be revealed(3 cases). Conclusion GBA involvement by gastric carcinomas shows some characteristic CT signs. GBA involvement by gastric carcinoma attributes to anatomic location and lymphatic drainage of PGC, also may be relevant to poor prognosis.