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Preoperative assessment of gastric artery in patients with gastric cancer by CT angiography on 64-slice spiral CT

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF RADIOLOGY
Issue:
3
DOI:
10.3760/cma.j.issn.1005-1201.2010.03.014
Key Word:
胃肿瘤;体层摄影术,X线计算机;Stomach neoplasm;Tomography,X-ray computed

Abstract: Objective To evaluate the efficacy of different three-dimensional CTA methods on 64-slice sprial CT in the preoperative assessment of gastric arteries and their variations.Methods Sixty-six consecutive patients with gastric cancer who underwent 64-slice spiral CT examinations preoperatively were retrospectively studied.To get the STS-MIP images, the thickness of slab was adjusted according to the inner diameter of targeted blood vessels and their cross-layer distribution.After four weeks, the AVVR images of all cases was got by the auto-vessel technique.The demonstration rates and origins of the direct and indirect feeding arteries were analyzed on AVVR and STS-MIP.McNemar tests were used to compare the detection rates of gastric feeding arteries by STS-MIP and AVVR.The relationship between CT value and display rate of vessels was analyzed using independent-samples t test The variations of blood vessels were analyzed.Results The display rate of indirect feeding arteries were all 100% (66/66) by STS-MIP and AVVR.The display rates of left gastric artery (LGA) and right gastroepiploic artery (RGEA) were 98.5% (65/66), 100.0% (66/66) and 97.0% (64/66), 100.0% (66/66) by STS-MIP and AVVR respectively.The display rates of right gastric artery (RGA), left gastroepiploic artery (LGEA), short gastric artery (SGA) and posterior gastric artery (PGA) by AVVR were lower than those of STS-MIP with statistical significances [RGA:68.2%(45/66) vs.98.5% (65/66), P<0.01; LGEA: 53.0% (35/66) vs.97.0% (64/66), P<0.01; SGA: 7.6% (5/66) vs.59.1 %(39/66), P<0.01; PGA: 18.2% (12/66) vs.63.6% (42/66), P<0.01 ].The demonstration rates of LGEA, RGEA and SGA increased accompanied with the increasing of CT value in celiac axis (LGEA: 35 cases displayed with mean CT value of (272±44) HU, 31 cases did not display with mean CT value of (229±42) HU, t=4.043, P<0.01; RGEA: 64 cases displayed with mean CT value of (256±44) HU, 2 cases did not display with mean CT value of (141 ±26)HU, (=3.641, P<0.01; SGA:5 cases displayed with mean CT value of (298 ±39),61 cases did not display with mean CT value of (249±47)HU, t=2.278,P<0.01). Thirteen cases (19.7%) with accessory left hepatic artery were identified, and seven cases (10.6%) with celiac axis variances were depicted.Conclusion 64-slice spiral CT can clearly demonstrate gastric feeding arteries and related variations, which may provide useful information for the operation of gastric cancer.Stomach neoplasm; Tomography, X-ray computedAVVR.The display rates of left gastric artery(I,GA) and fight gastroepiploic artery(RGEA)were 98.5%(65/66),100.0%(66/66)and 97.0%(64/66),100.0%(66/66)by STS-MIP and AVVR respectively.The display rates of right gastric artery(RGA),left gastroepiploic artery(LCEA),short gastric arterysignificances [RGA:68.2%(45/66)VS.98.5%(65/66), P<0.01;ICEA:53.0%(35/66)VS.97.0%(64/66),P<0.01;SGA:7.6%(5/66)VS.59.1%(39/66),P<0.01;PGA:18.2%(12/66)VS.63.6%(42/66).P<0.01 1.The demonstration rates of I.GEA,RGEA and SGA increased accompaniedwith the increasing of CT value in celiac axis(LGEA:35 cases displayed with mean CT value of(272±44)HU,31 cases did not display with mean CT value of(229±42)HU,t=4.043,P<0.01;RGEA:64 cases displayed with mean CT value of(256±44)HU,2 cases did not display with mean CT value of(141±26)HU,t=3.641, P<0.01;SGA:5 cases displayed with mean CT value of(298±39),61 casesaccessory left hepatic artery were identified.and seven cases(10.6%) with celiac axis variances werevariations.which may provide useful information for the operation of gastric cancer.

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