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目的:探讨隐蔽区胃癌的影像检查技巧与诊断要点。方法:20例隐蔽区胃癌均行钡剂造影检查,发生于胃底后壁7例,胃底后壁小弯侧13例,其中贲门管受累9例。20例中16例术前行胃镜检查,全部病例均经胃肠钡餐造影检查。结果:20例胃底后壁癌19例手术切除,其中2例病变与脾脏粘连将脾脏一并切除。1例年龄大(74岁)心功能不全而保守治疗,随访2a肿瘤由隆起性病变形成巨大溃疡。20例病理报告均为腺癌。结论:隐蔽区胃癌因其发病位置相对特殊,前后左右相互重迭或病变位于贲门后上方,不论钡剂造影及胃镜检查均易漏诊或病变范围不易确定,因此,如何掌握本病的检查技巧是提高本病检出率的重要环节。
Objective: To explore the imaging technique and diagnosis points of gastric cancer in hidden area. Methods: Twenty patients with gastric cancer in hidden area underwent barium contrast imaging. Seven cases occurred in the posterior wall of the fundus, 13 in the lesser curvature on the posterior wall of the fundus, and 9 in the cardia. In 20 cases, 16 cases underwent preoperative gastroscopy, all cases were confirmed by gastrointestinal barium meal angiography. RESULTS: Twenty-nine cases of gastric fundus and posterior wall cancer were surgically removed. Two of the lesions were removed with spleen adhesion. A case of older (74 years) cardiac insufficiency and conservative treatment, follow-up 2a tumor formed by bulging lesions of large ulcers. Twenty cases of pathological reports were adenocarcinoma. Conclusions: Because of the special location of concealed gastric cancer, the overlap of the anterior, posterior, left and right or above the cardia, it is difficult to determine whether the barium and gastroscopy are missed or the range of the lesion is difficult to determine. Therefore, Improve the detection rate of the disease an important part.