目的 探讨MSCT及X线气钡双对比造影对浸润型胃淋巴瘤和浸润型胃癌的鉴别诊断价值。方法 回顾性分析经病理证 实的13例浸润型胃淋巴瘤和24例浸润型胃癌患者MSCT及X线气钡双对比造影的影像表现。观察病变部位、胃壁厚 度、强化程度、胃腔、黏膜及浆膜改变特征、胃周淋巴结及其他器官侵犯特点。结果 浸润型胃淋巴瘤和浸润型胃 癌累及多部位者分别占77%和16%。胃壁厚度分别为7-60mm(平均为21.3mm)和8-26mm(平均为12.4mm)。增强后胃淋巴 瘤呈轻中度强化，强化增加值小于20HU，少见坏死；浸润型胃癌有明显不均匀强化并可见黏膜面出现“白线征”。 胃腔形态固定、狭窄及梗阻者分别占8%和100%。病变部胃腔扩张度大于50%者分别为92%和0%。显示病灶处胃壁浆膜 面光滑，胃周脂肪间隙清晰者分别占92%和0%。肝脾肿大者分别为85%和0%。肾门以下腹膜后淋巴结浸润者分别为 61%和8.3%。两组病例比较有显著性差异(P<0.05)。结论 MSCT结合X线气钡双对比造影对浸润型胃淋巴瘤和浸润型 胃癌鉴别诊断有重要的临床价值。

Objective To observe the differential diagnostic value of MSCT and double contrast barium features of gastric lymphoma and gastric carcinoma. Methods A total of 13 cases of gastric lymphoma and 24 cases of advanced gastric carcinoma confirmed by pathologically underwent MSCT and double contrast barium examination. CT findings, including location, contour, extent, thickness of gastric wall, the enhancement pattern, and the situation of gastric cavity and gastric mucosa, and the encroachment of lymph nodes and other organs were observed. Results Gastric wall thickening involved multiple sites in 10(77% ) cases of gastric lymphoma, and in 4(16% ) cases of advanced gastric carcinoma. CT demonstrated irregular thickening of the gastric wall (7-60 mm)and (8-26 mm), White line sign was observed in 24 cases (100% ) of advanced gastric cancer, but none in gastric lymphoma. The extent more than half of gastric circumference was seen in 12(92%) cases of gastric lymphoma, while none cases of advanced gastric carcinoma. 12(92%) cases of advanced gastric carcinoma and none cases of gastric with deep ulcers Stomach expansion without distal was found in only 1 (8%) cases of gastric, but all cases of advanced gastric cancer. 12(92%) cases were found to have clearly fat planes in gastric lymphoma, but none in advanced gastric carcinoma. Conclusion There are some CT features to differentiate advanced gastric cancer from gastric lymphoma.