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Objective:To investigate the application value of multi-slice spiral CT (MSCT) in Borrmann classification of advanced gastric cancer.Methods:The clinical data of 80 patients with advanced gastric cancer who received treatment in Cixi Integrated Traditional Chinese and Western Medicine and Health Group from January 2016 to January 2020 were analyzed. Clinical results were compared with MSCT imaging findings.Results:Postoperative specimens of 80 patients with gastric cancer showed that a single cancer occurred in cardiac fundus of 13 (16.25%) patients, in gastric body of 21 (26.25%) patients, in gastric antrum of 46 (57.50%) patients. Advanced gastric cancer involved gastric fundus and gastric body in 21(26.25%) patients, gastric antrum and gastric body in 34 (42.50%) patients, and gastric fundus, gastric body and gastric antrum in 13 (16.25%) patients. Pathological results of gastric cancer showed Borrmann type I in 12 (15.00%) patients, Borrmann type II in 28 (35.00%) patients, Borrmann type III in 27 (33.75%) patients and Borrmann type IV in 13 (16.25%) patients. The accuracy rate of preoperative MSCT in the identification of Borrmann type I, II, III and IV gastric cancer was 83.33%, 78.57%, 77.78%, and 84.62%, respectively, with the total preoperative MSCT accuracy rate of 80.00%. Preoperative MSCT has good intra-observer consistency and inter-observer consistency in the Borrmann classification of advanced gastric cancer, with the kappa values of 0.883 and 0.853, respectively ( P < 0.001). Conclusion:MSCT has a high accuracy rate and good repeatability in Borrmann typing of advanced gastric cancer.
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Objective To analyze the CT manifestation and clinical characteristics of appendiceal mucinous tumor for improving the diagnostic and therapeutic level. Methods The CT and clinical data of 7 patients with appendiceal mucinous tumor verified by histopathology were retrospectively analyzed. Results Among the 7 cases, mucinous cystadenomas was in 6 cases, and mucinous cystadenocarcinoma was in 1 case. One case had no obvious discomfort;3 cases visited because of pain on right hypogastrium and fever;3 cases had the medical history ofchronic appendicitis, among whom 2 cases had the mass on right hypogastrium which had existed for 1 day or 2 years. The unenhanced CT showed that all of 7 cases had the cystic tumors on right hypogastrium near the cecum, and the maximum traverse diameter was 25-208 (67 ± 27) mm. The cyst walls of mucinous cystadenoma in 6 cases were flimsy, symmetrical, 2.3-3.5 mm thickness and smooth. Three cases had cyst walls calcification; the cyst wall of mucinous cystadenocarcinoma was thick and asymmetrical, and the thickness of cyst wall was 3.5-5.7 mm. Small nodes could be found inside the walls. 7 cases had much mucilage, with CT value 14.0-33.5 HU. Four cases had slight septa. The enhanced CT showed that the cyst walls of mucinous cystadenoma in 6 cases were mild to moderate continuous enhancement during venous phase; the cyst wall and nodes mucinous cystadenocarcinoma was obvious and continuous enhancement. Four cases showed clear boundary, while 3 cases accompanied with acute inflammation showed dim edge. The enlargement of lymphatic nodes could be seen near mesentery in 1 case. All the 7 cases were treated by surgical treatment. One patient who survived after 26 months showed the metastasis of peritoneal pseudomyxoma after 20 months. The 6 patients with mucinous cystadenoma were followed up for 18 - 36 months, they did not had metastasis or recurrence by CT review. Conclusions Appendiceal mucinous tumor is often short of characteristic in clinical symptom and physical sign, but has favourable prognosis. CT is a vital tool for its diagnosis and identification.
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Objective To explore the CT characteristics of mucinous cystadenocarcinoma of appendix.Methods The CT findings of 5 patients with mucinous cystadenocarcinoma of appendix proved by surgery and pathology were analyzed retrospectively,and the corresponding literatures were also reviewed.Results All lesions in 5 patients showed cystic changes in the right hypogastrium inclu-ding irregular shape with lobulation in 4 and tubular shape in 1.The maximum traverse diameters ranged from 27 mm to 146 mm. Unclear boundary was showed if the lesion invaded the adjacent gut.The cystic wall was asymmetry and thickened with little nodes and nipple in the inner wall.The thick septa were seen in 3 tumors.Much mucus was seen in tumors with uneven density and average CT value of 1 9.3 HU-34.6 HU.On enhanced CT,obvious enhancement of the cystic wall and septa in 4 and moderate enhance-ment in 1 was showed.The adjacent fatty gap of 3 tumors were clear,however it was vague when accompanied with acute inflamma-tion.Small calcification in 3 and enlarged lymphatic nodes in 3 were also found.Conclusion CT shows some characteristics of mu-cinous cystadenocarcinoma of appendix and plays an important role in the diagnosis of the disease.