Evaluation of spiral CT in staging of gastric carcinoma and preoperative assessment according to the classification of Lauren / 中华消化杂志

ABSTRACT

Objective To investigate the role of the classification of Lauren in staging of gastric carcinoma and preoperative assessment using spiral CT. Methods Forty eight patients, 32 men and 16 women, who were 24～78 years old, with histologically and endoscopically proven gastric carcinoma, underwent spiral CT scans in prone position, with drug induced hypotonia and water filling. To induce gastric wall hypotonia and to maintain it during the entire examination, 10～15 mg of 654 2 was administered iv before basal scanning. All patinets underwent 2D, 3D and axial imaging using spiral CT, and 46 patients underwent dual phase contrast within one breathhold each. All patients with gastric carcinoma underwent staging and preoperative assessment by two radiologists according to the classification of Lauren. Results Spiral CT correctly detected all tumours. In our series, gastric carcinoma was of the diffuse type in 33 cases, of intestinal type in 15 cases; first stage in 2 cases, second stage in 18 cases, third stage in 15 cases and forth stage in 13 cases. There were 40 patients being performed operation, gastrectomy was performed in 33 patients and laparotomy was performed in 7 patients. The staging and preoperative assessment accuracy was 85.4% and 95.0% respectively, overstaging was 10.4%, and understaging was 4.2% according to the classification of Lauren. Correct rate of spiral CT detected lymph nodes (N1,N2) was 74.1% and 82.7% respectively. There are about 18 patienes whose arteries were invaded by tumors. With dual phase contrast, spiral CT can get well in detecting tumour, especially in staging gastric carcinoma in artery phase. Conclusions The classification of Lauren is recommended for staging of gastric carcinoma and preoperative assessment using spiral CT.