目的 探讨多层螺旋CT增强扫描 在诊断胃癌淋巴结转移中的临床应用价 值，并研究转移淋巴结的螺旋CT增强扫 描特征。方法 回顾性分析我院2011年1 月-2014年7月入院治疗的73例胃癌患者 的就诊资料，将患者的多层螺旋CT增强 扫描诊断结果分别与病理分析结果和平 扫诊断结果对照。结果 多层螺旋CT增 强扫描诊断胃癌淋巴结转移的诊断符合 率为86.3%，敏感度为86.2%，特异度为 86.7%；多层螺旋CT增强扫描对转移淋巴 结的检出率及诊断准确性高于螺旋CT平 扫，P<0.05，其差异有显著性意义；转移 淋巴结的主要螺旋CT征象:较小转移淋巴 结以实体性为主，随直径增大呈环状、囊 状改变者增加；强化类型分为实体性均匀 强化，环带样强化和囊状不强化；强化峰 值时间不同，以动脉期达强化峰值者多 见。结论 螺旋CT增强扫描能够提高淋巴 结转移的诊断准确性，对术前全面评价淋 巴结转移状况有重要临床价值。

Objective To investigate the diagnostic value of tri-phasic enhanced spiral CT in the diagnosis of lymph node metastasis in gastric carcinoma as well as its CT stations. Methods Retrospective analysis the data of 73 patients with meningioma confirmed by surgery and pathology in our hospital from January 2011-July 2014. Both plain and tri-phasic enhanced spiral CT scan of upper abdomen were performed in 73 patients with advanced gastric carcinoma, and the results were correlated with the surgical and pathologic findings. Results The degree of lymph node enhancement was higher in arterial phase compared with that in venous and delay phases, For the tri-phasic enhanced spiral CT scan, the accuracy was 86.3%,sensitivity 86.2%,specificity 86.7%,respectively.The diagnosis accuracy and detectability of metastatic lymph node by triphasic enhanced spiral CT is better than that of plain scan, there was significant statistical difference between the two groups(P<0.05). The main features of lymph node metastases of gastric carcinoma with plain and tri-phasic enhanced spiral CT scan were solid and homogeneous pattern, mainly in small lymph node; annular or cystic pat-tern in bigger nodes. Conclusion The diagnostic accuracy of lymph node metastases in advanced gastric carcinoma can be improved by tri-phasic enhanced spiral CT.