Superiority of IV bolus CT in evaluation of metastatic lymphadenopathy in th stomach cancer

ABSTRACT

Differentiation of lymph node from vessels or bowel wall with similar clearity is often difficult in conventional contrast-enhanced computed tomography (CCCT). For optimal differentiation of these structures, arterial-phase dominent CT images by IV bolus injection and rapid scan were obtained. The images were compared from those by CCCT in evaluation of lymphadenopathy. Seventy patients, diagnosed as stomach cancer by pathology, were selected for this study. There were 14 cases of equivocal lymphadenopathy on CCCT while IV bolus CT revealed lymphadenopathy in 9 of there and no lymphadenopathy in the rest. Among the 38 cores without lymphadenopathy on CCCT, IV bolus CT detected 4 lymphadenopathy. In 30 node dissection cases, when we decided 1cm as CT criterion for lymphatic enlargement, the sensitivity and the specificity that there were lymphatic enlargement in gross of lymphatic infiltration above one fourth in pathology even though no lymphatic enlargement in gross were 100%. On conclusion, IV bolus CT is more helpful method to evaluate lymphadenopathy than CCCT and compatible with pathologic findings when we decide 1cm as CT criterion for lymphadenopathy. In conclusion, IV bolus CT is superior to CCCT in evaluation of metastatic Lymphadenopathy when using CT Criferion of 1cm as the diameter of enlarged lymph node.