目的 旨在探讨胃癌螺旋CT三期 增强图像表现特征及诊断价值。方法 选 取我院2013年10月-2016年10月收治的胃 癌患者50例，收集50例患者的临床资料、 影像学资料，分析50例胃癌患者 CT三期 增强扫描的图像表现，并以病理学检查 结果为标准，比较CT增强扫描对胃癌的 检出率及诊断准确率。结果 CT平扫对胃 体部、胃窦部胃癌的检出率、诊断准确率 明显低于CT三期增强扫描，差异具有统计 学意义（P<0.05）；CT平扫对胃癌总检出 率、诊断准确率为74.00%、50.00%，明显 低于CT三期增强98.00%、96.00%，差异具 有统计学意义（P<0.05）；CT平扫中患者 图像表现出不同程度的胃壁增厚，广泛增 厚者未见胃壁自然弧度，胃壁僵硬，胃轮 廊不清，周围脂肪层模糊或完全消失。CT 三期增强中，胃腔内、胃壁内外对比梯度 较佳，可直观显示肿瘤大小、形态及与毗 邻组织结构，36例患者增强扫描图像中均 显示胃壁增厚变化不均匀，胃体内肿块向 腔内外突出，侵犯周围组织。41例患者病 灶内侧粘膜层明显强化，门脉期强化面积 增大，平衡期完全强化。结论 螺旋CT三 期增强扫描可清楚显示胃癌病灶图像表现 特征，检出率及诊断准确高，可为临床治 疗提供可靠影像学资料。

Objective To investigate the characteristics and diagnostic value of spiral CT three phase enhanced imaging in gastric cancer. Methods 50 patients with gastric cancer treated in our hospital from January 2015 to December2016 were selected,the clinical data and imaging data of 50 patients were collected, analysis of 50 cases of gastric cancer patients with CT scan and CT three phase enhanced scan image performance, the detection rate and diagnostic accuracy of CT plain scan and CT three phase enhanced scan were compared with the pathological examination results as the standard. Results The detection rate and diagnostic accuracy of CT scan in gastric body and gastric antrum were significantly lower than those of CT three phase scan,the difference was statistically significant (P<0.05). The total detection rate and diagnostic accuracy of CT scan for gastric cancer were 74.00% and 50%, which were significantly lower than those of CT three, 98.00% and 96.00%, and the difference was statistically significant (P<0.05). CT scan images of patients showed different degrees of thickening, thickening of gastric wall was extensive natural radian, gastric wall stiffness, the stomach contour is not clear, the surrounding fat layer fuzzy or disappear completely. In the three phase of CT enhancement, the contrast gradient in gastric antrum and gastric wall was better, which can directly display the size, shape and adjacent tissue structure of tumor, in 36 patients, the thickened wall of stomach showed uneven changes, and the masses in the stomach were prominent inside and outside the cavity, which could directly invade the surrounding tissues. The medial mucosa lesions in 41 patients showed obvious enhancement, portal phase area increased and the equilibrium period completely enhanced. Conclusion Spiral CT three phase enhanced scan can clearly display the image features of gastric cancer lesions,the detection rate and diagnostic accuracy are high, which can provide reliable imaging data for clinical treatment.