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KMID : 0386120010450030291
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Journal of the Korean Radiological Society
2001 Volume.45 No. 3 p.291 ~ p.296
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Efficacy of Spiral CT in the Evaluation of Peritoneal Seeding of Gastric Cancer
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Choi Hyuck-Jae
Han Jun-Gu
Kim Tae-Kyung
Kim Ah-Young
Lee Joon-Woo
Moon Min-Hwan
Yang Han-Kwang
Choi Byung-In
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Abstract
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Purpose: To determine usefulness of spiral CT in the preoperative evaluation of peritoneal seeding from a gastric carcinoma.
Materials and Methods: From a database of 411 consecutive patients with surgically proven advanced gastric cancinoma obtained over a six-month period, 17 with peritoneal seeding and a control group of 24 without peritoneal seeding underwent spiral CT scanning with 7 -8 mm scan thickness and interval during the portal phase. Preoperative CT images were analyzed by two readers who reached a consensus with regard to the presence and location of the ascites, thickening of the parietal peritoneum, and changes in the omentum and mesentery.
Results: Ascites was present in 47% (8/17) of patients with peritoneal seeding The right subhepatic space (n=6, 35%) and right paracolic gutter (n=5, 29%) but not the cul-de-sac (n=2, 12%)-were common sites of fluid collection. Permeative changes in the omentum and mesentery were seen in 18% (3/17) and 12% (2/17) of patients, respectively. Among five controls with false positive results, ascites in the cul-de-sac was present in three (two males and one female, 12%) while omental nodules and a thickened peritoneum were found in two (8%) and one (4%), respectively. In nine controls with false negative results, small disseminated nodules were seen in the mesentery and omentum at surgical field. The sensitivity and specificity of spiral CT were 47% (8/17) and 79% (19/24), respectively.
Conclusion: ,In terms of sensitivity and specificity, spiral CT is not especially accurate in distinguishing peritoneal seeding from gastric carcinoma.
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KEYWORD
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Stomach, neoplasms, Peritoneum, neoplasms, Computed tomography (CT),
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