위암 환자에서 위아전절제술 후 부분 비후된 위벽의 CT 소견: 재발암과 양성 비후의 비교

초록

OBJECTIVE: To evaluate the accuracy of computed tomography (CT) criteria for differential diagnosis between tumor recurrence and chronic gastritis of remnant stomach in patients who have undergone subtotal gastrectomy with stomach cancer. MATERIALS AND METHODS: Sixty-four patients were pathologically proven as recurred stomach cancer in 11 patients and chronic gastritis in 53 patients. Without knowledge of clinical information, we retrospectively reviewed the CT findings: the thickness of gastric wall adjacent anastomosis site and opposed side wall, enhancement pattern and margin of thickened gastric wall, perigastric fatty infiltration and lymphadenopathy, and metastatic lesions. The statistical analysis of these findings was performed for establish the useful criteria for the detection of tumor recurrence. RESULTS: Mean thickness of recurred mass and gastritis was 16.2+3.8 cm and 11.3+3.9 cm, respectively. Gastric wall ratio of recurred mass and gastritis was 2.9+1.5 and 1.7+0.6, respectively. More than 1.6 cm of thickness and 2.5 of gastric ratio were most sensitive and specific criteria for diagnosis of tumor recurrence. Heterogeneous enhancement, lobulated margins, perigastric fatty infiltration and regional lymph nodes were significantly commonly detected in recurred cancer (p<0.05), Hepatobiliary metastasis, paraaortic lymphadenopathy and ascites were not significantly different between recurrence and gastritis. CONCLUSION: Careful assessment of thickness and feature of remnant gastric wall and perigastric fatty infiltration, regional lymphadenopathy can be useful criteria for diagnosis of reccured cancer in subtotal gastrectomy patients with stomach cancer.