Efficacy of Spiral CT in the Evaluation of Peritoneal Seeding of Gastric Cancer.
10.3348/jkrs.2001.45.3.291
- Author:
Hyuck Jae CHOI
1
;
Joon Koo HAN
;
Tae Kyoung KIM
;
Ah Young KIM
;
Joon Woo LEE
;
Min Hoan MOON
;
Han Kwang YANG
;
Byung Ihn CHOI
Author Information
1. Department of Radiology, Seoul National University College of Medicine and the Institute of Radiation Medicine, SNUMRC.
- Publication Type:Original Article
- Keywords:
Stomach, neoplasms;
Peritoneum, neoplasms;
Computed tomography (CT)
- MeSH:
Ascites;
Consensus;
Female;
Humans;
Male;
Mesentery;
Omentum;
Peritoneum;
Sensitivity and Specificity;
Stomach Neoplasms*;
Tomography, Spiral Computed*
- From:Journal of the Korean Radiological Society
2001;45(3):291-296
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
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.
