Diagnostic analysis of images of endoscopic-CT cases of stomach cancer.)

【Clinical History】

Male, 44 years old, hypophthalmic pain with vomiting for more than half a year, aggravated for 1 week

【Image image】Flat sweep

intensifier

gastroscope

【Image Performance】

CT findings: localized thickening of the gastric wall in the antrum (Fig.

【Diagnosis】

gastric cancer

【Differential Diagnosis】

1.

【Discussion】

Stomach cancer (carcinoma of stomach) is one of the common malignant tumors of the digestive system, more common in men, the age of onset is 40 to 60 years old, from the point of view of the site of onset, the gastric small curvature antrum is the most common, accounting for 50% to 60%, followed by the cardia gastric base area, the lowest incidence of the stomach body and the great curved side

Key points of imaging diagnosis:

Endoscopy: Endoscopy combined with mucosal biopsy is currently the most reliable diagnostic modality

X-ray: early gastric cancer: low-tension double contrast contrast

(1) The structure of the mucous membrane of the gastric cell is disordered and disappears

(2) A small niche shadow of a spike-like process can be seen at the tangent position

(3) Visible granular, small round filling defects, rough surface hair

Fig.

CT examination: a flat scan can see irregular soft tissue anticular cavity, diffuse or localized thickening of the gastric wall (CT images generally regard the thickness of the gastric wall > 10 mm as abnormal, but if the local thickening is found, even if the < 10 mm, it should be regarded as abnormal), and the wall is not smooth

MRI: MRI signaling in advanced gastric cancer shows medium or slightly lower signal of T1WI and medium high signal

Distinguish from gastric lymphoma: it is more likely to occur in people over 40 years old, and it is more likely to occur in the stomach body and antrums

Distinguished from stromal tumors: benign tumors that occur in the muscle layer of the stomach, slightly more often in men, and tend to occur in 50 to 60 years of age

Distinguished from interstitial sarcoma: clinical symptoms are obvious, the course of the disease is short, the tumor grows rapidly, bleeding, liquefaction and necrosis are common, and ulcers are often formed

【Question】

(2) Lesions manifested as localized thickening of the stomach wall Right: Wrong

(3) The lesion did not see strengthening Right: Wrong

(4) Peripheral lymph node metastases Right: Wrong

(5) Lump extragastric invasion Right: Wrong

Correct answer: 1:√ 2:√ 3:× (lesion significantly strengthened) 4:√ 5:√