The gastric cancer is the most common malignancy in Korea and most of gastric cancers are advanced at the time of detection. Computed tomography(CT) is one of the most simple, rapid and noninvasive methods of accurate diagnosis and staging of
gastric
malignancy.
Authors retrospectively analysed the preoperative abdominal CT findings in 96 cases of pathologically proved gastric malignancies after surgery for 44 months from January 1988 to August 1991 at Department of Surgery. Hangang Sacred Heart
Hospital,
Hallym University.
@ES The results were as follows :
@EN 1) Thickened gastric wall on the CT scan was seen in 81.2% of all patients and 21.4% of patients of early gastric cancer(EGC) respectively when a moderately distended stomach had a wall more than 10 mm in thickness.
2) CT images of pancreatic invasions had a sensitivity of 72.2%, a specificity of 73.3% and an accuracy of 72.9%.
3) CT images of regional lymph node metastases had a sensitivity of 46.3%, a specificity of 85.7%, and an accuracy of 61.8%.
4) CT images of distant metastases had a sensitivity of 75%, a specificity of 98.8% and an accuracy of 94.8%. An accuracy of liver metastases in CT images was 66.7%.
5) About a half of the patients were correctly staged with CT, but in another half of them CT staging was usually understaged when compared with TNM staging and usually overstaged when compared with PHNS staging.
6) An accuracy of CT images in the assessment of operability was 96.6% and the palliative operations were usually performed in stage IV patients by CT images.
In conclusion, preoperative CT is not always necessary in the case of early gastric cancer but it would be one of the important tools for determining the extent of advanced gastric cancer, though it has a low accuracy rate in assessment of lymph
node
metastasis and staging.
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