The superiority of 256-slice spiral computed tomography angiography for preoperative evaluation of surrounding arteries in patients with gastric cancer

Abstract

Objective

To evaluate the utilization of 256-slice spiral computed tomography (CT) angiography in preoperative assessment of perigastric vascular anatomy in patients with gastric cancer.

Methods

In this study, 80 gastric cancer patients were included. The medical procedure of 256-slice spiral CT angiography was performed on each of these patients consecutively. Thereafter, these patients were subjected to surgical treatment in our hospital. The techniques of volume rendering (VR) and maximum intensity projection (MIP) were used to image reconstruction of arteries around the stomach.

Results

Both VR and MIP were applied to reconstruct the images of perigastric arteries. The results indicated that VR imaging was inferior to MIP in determining the variant small artery anatomy around the greater curvature and fundus. The respective rates of imaging produced by VR and MIP for left gastroepiploic artery, short gastric artery, and posterior gastric artery, were 32.50% versus 100%, 16.25% versus 87.50%, and 3.75% versus 25.00%, respectively. According to Hiatt’s classification, 75 out of 240 cases were abnormal types, among which we found Type II in 30 cases, Type III in 33 cases, Type IV in three cases, Type V in six cases, and Type VI in only three cases. There was no significant difference for total and every single variation type, between our group and Hiatt’s group (P>0.05).

Conclusion

The 256-slice spiral CT angiography can be regarded as an effective and accurate diagnostic modality for preoperative assessing anatomical arterial variations in gastric cancer; MIP was superior to VR at identifying variations of some small artery, whereas VR was better than MIP at showing anatomical arterial variations due to its three-dimensional effect.

Keywords:

• gastric cancer
• artery
• angiography
• tomography
• spiral computed

Acknowledgments

Thanks to Cao Xi-Da, Zhen Jun-Hui, and Wang Si-Yun from the Department of Radiology for the assistance they provided to get numerous CT dates together. This work was supported by Guangdong Provincial Natural Scientific Foundation (number S2011010001430), Guangdong Science and Technology Department Scientific Foundation (number 2010B060900064), Science Department of Guangzhou Scientific Foundation (number 2010Y1-C121), Yuexiu Science and Information Center of Guangzhou Scientific Foundation (number 2012-GX-046), and National Natural Scientific Foundation of China (number 81001112).

Disclosure

The authors report no conflicts of interests in this work.