目的从多中心搜集资料，研究 螺旋CT间接淋巴造影及多期增强扫描评 估胃癌前哨淋巴结的方法及意义。方法 2012年6月到2014年6月珠海市第五人民医 院影像科采集数据。从无胃癌T0(50例)、 cT1-2病人(35男29女)取得SLN标本。SLN 影像检查和活检和随后的腹腔镜胃切除 术、剖腹胃全切术及胃部分切除术均在 珠海市第五人民医院进行。所有研究对 象行螺旋CT间接淋巴造影技术及多期增 强扫描。结果 T0、Tis、T1、T2、T3之 间，间接淋巴造影、多期增强扫描、间接 淋巴造影+多期增强扫描、活检四种方法 的检出人数没有差异。T4时，间接淋巴 造影检出51例(62.96%)，多期增强扫描 检出61例(75.30%)，间接淋巴造影+多期 增强扫描检出81例(100.0%)，X2 =9.271， P=0.000。N1、N2在间接淋巴造影、多期 增强扫描、间接淋巴造影+多期增强扫 描、活检四种方法的检出人数均有统计 学差异(P＜0.05)。N1四种方法的X2 是： 6.262，N2四种方法的X2 是：3.199。螺旋 CT三期增强扫描比间接CT淋巴结造影检出 率高，X2 =8,.482，P=0.000。结论 采用 螺旋CT间接淋巴造影技术及多期增强扫描 对胃癌前哨淋巴结作出术前判断，可为胃 癌前哨淋巴节清扫提供术前及术中依据， 为胃癌微创手术临床应用打下基础，准确 的胃癌分期诊断及淋巴结累及情况的判断 也为手术提供影像学参考，从而达到胃癌 合理临床手术治疗。

Objective To evaluate the significance of spiral CT, indirect lymphography and multi phase enhanced scan on sentinel lymph node in gastric cancer. Methods The data were collected from the department of image in the Fifth People's Hospital of Zhuhai city during 2012 June to 2014June. SLN samples were obtained from the T0 of gastric cancer (50 cases), cT1-2patients (35 male and 29 female). All checks were performed in the Fifth People's Hospital of Zhuhai city, such as SLN imaging, biopsy and subsequent laparotomy laparoscopic gastrectomy, gastric partial hysterectomy and gastricresection. And all the patients were underwent spiral CT indirect lymphography and multi phase enhancement scanning. Results During the T0, Tis, T1, T2, T3 period, the detected number between indirect lymphography, multi phase enhanced scanning, indirect lymphography + multiphase enhanced scanning and biopsies had no difference. But during the T4 period, indirect lymphography detected 51 cases (62.96%), multi phase scan detected 61 cases (75.30%), indirect lymphography + multi phase scan detected 81 cases (100%), and there was significant difference between the four methods (X2 =9.271, P=0.000). The detected number of N1, N2 in the four methods were statistically significant difference (P <0.05) , the X2 value were 6.262, 3.199 respectively. The detection rate of helical CT three phases enhanced images was higher than that used indirect CT lymphography (X2 =8.482, P=0.000). Conclusion Spiral CT indirect lymphography and multi phase enhanced scan of sentinel lymph node in gastric cancer can help us make judgment and provide preoperative and intraoperative basis for sentinel gastric cancer sentinel lymph node cleaning，and lay the foundation for the clinical application of minimally invasive operation of gastric cancer. Meanwhile the accurate staging of gastric cancer and lymph node involvement judgment also provides image reference for operation, so as to achieve the reasonable operation of gastric cancer clinical treatment.