Brief Article
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World J Gastroenterol. Sep 14, 2013; 19(34): 5732-5737
Published online Sep 14, 2013. doi: 10.3748/wjg.v19.i34.5732
Application value of multi-slice spiral computed tomography for imaging determination of metastatic lymph nodes of gastric cancer
Chun-Lai Dai, Zhi-Gang Yang, Li-Ping Xue, Yu-Mei Li
Chun-Lai Dai, Zhi-Gang Yang, Department of Radiology, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Li-Ping Xue, Press of Maternal and Child Health Care of China, Medicine Periodical House of Jilin Province, Changchun 130061, Jilin Province, China
Yu-Mei Li, Department of Pediatrics, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Dai CL was in charge of experimental design and carrying out the study; Yang ZG and Xue LP were responsible for image collection and after treatment at the workstation; Li YM took charge of collecting and analyzing data.
Supported by Jilin Provincial Science and Technology Department No. 201015158, No. 20110922; and Jilin Provincial Administration of Traditional Chinese Medicine, No. 2011-JS20
Correspondence to: Yu-Mei Li, MD, Professor, Department of Pediatrics, the First Hospital of Jilin University, Xinmin Street No. 1, Changchun 130021, Jilin Province, China. liyumei1988@126.com
Telephone: +86-431-88783976 Fax: +86-431-88783975
Received: May 27, 2013
Revised: July 29, 2013
Accepted: August 12, 2013
Published online: September 14, 2013
Abstract

AIM: To evaluate the application value of multi-slice spiral computed tomography (MSCT) for imaging determination of metastatic lymph nodes of gastric cancer and to explore reasonable diagnostic criteria.

METHODS: Sixty patients with gastric cancer underwent 64 MSCT scans before operation. Gastric cancer samples and perigastric lymph nodes were obtained after operation, formalin fixation and haematoxylin-eosin staining. The metastatic conditions of gastric cancer and perigastric lymph nodes were determined under a light microscope. A total of 605 lymph nodes were grouped and assessed according to distribution, size, shape and degree of lymph node enhancement. Then, the findings were compared with the postoperative pathological results.

RESULTS: Among 605 lymph nodes, 358 were confirmed as metastatic, accounting for 59.2%. A total of 535 lymph nodes were detected in original axis images combined with multiplanar reconstruction images of MSCT. The metastatic lymph nodes had specific signs in computed tomography. This study showed that the long diameter of lymph nodes ≥ 8 mm indicated metastasis; the sensitivity and specificity were 79.6% and 78.8%, respectively. The difference of the mean value of lymph node enhancement density ≥ 80 Hu indicated metastasis; the sensitivity and specificity were 81.6% and 75.6%, respectively. The ratio of short diameter to long diameter of lymph nodes ≥ 0.7 indicated metastasis; the sensitivity and specificity were 85.6% and 71.8%, respectively.

CONCLUSION: MSCT is a non-invasive and reliable method for preoperative examination of gastric cancer. Sensitivity and specificity for prediction of lymph node metastasis are high.

Keywords: X-ray computer, Gastric cancer, Metastatic lymph nodes

Core tip: Gastric cancer is one of the most common malignant tumours of the digestive system. In recent years, individualised surgical therapy has been applied for gastric cancer. This study plan explored the distribution, size, shape and enhancement characteristics of metastatic lymph nodes. It also provided a basis for determining lymph node metastasis before surgery by retrospectively analyzing multi-slice spiral computed tomography manifestations of lymph nodes of patients with gastric cancer after surgery in the hospital. The findings were compared with the pathological results.