medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.medvis-3Research ArticleБРЮШНАЯ ПОЛОСТЬABDOMENДиагностика метастатического поражения регионарных лимфатических узлов при раке желудка. Часть 1: КТ-анатомия регионарных лимфатических узловAssessment of Lymph Node Status in Gastric Cancer. Part 1: CT-anatomy of Regional Lymph NodesАгабабянТатев АртаковнаAgababianTatev Artakovnatatevik.05@mail.ruСилантьеваНаталья КонстантиновнаSilantevaNatalya Konstantinovnanoemail@neicon.ruФГБУ "Медицинский радиологический научный центр" Министерства здравоохранения РоссииРоссияMedical Radiological Research Center of the Russian Ministry of HealthRussian Federation201428022014011421Copyright © Агабабян Т.А., Силантьева Н.К., 20142014Агабабян Т.А., Силантьева Н.К.Agababian T.A., Silanteva N.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/3

Цель: представление КТ-анатомии регионарных лимфатических узлов при раке желудка. Материал и методы. Работа основана на данных литературы и результатах МСКТ-обследования 91 больного раком желудка. Исследования проводили на аппаратах Somatom Emotion 6 и Somatom Sensation Open (Siemens). Результаты. На основе Японской классификации рака желудка разработана КТ-схема последовательности оценки регионарных лимфатических узлов, которая включает в себя 10 групп в соответствии с зонами их анатомического расположения: лимфатические узлы в зоне пищеводного отверстия диафрагмы, кардиальные, малой кривизны, печеночно-дуоденальной зоны, чревные, селезеночные, большой кривизны, брыжейки поперечно-ободочной кишки, перипанкреатические и парааортальные. Выводы. Знание КТ-топографии регионарных лимфатических узлов с четко обозначенными названиями их групп позволяет врачам-рентгенологам повысить точность диагностических заключений и оценить степень лимфогенной распространенности рака желудка.

Purpose: presentation of CT anatomy of regional lymph nodes in gastric cancer Materials and methods. The work is based on the literature data and the results of MDCT 91 patients with gastric cancer. The study was performed with a multidetector row CT scanners (Somatom Emotion 6 and Somatom Sensation Open; Siemens, Germany). Results. On the basis of the Japanese classification of gastric carcinoma we grouped the regional lymph nodes sites into 10 areas that could be easily visualized by CT: lymph nodes of diaphragmatic esophageal hiatus, lesser curvature, cardial, hepatoduodenal, celiac trunk, splenic, greater curvature, mesocolon, peripancreatic and para-aortic. Conclusion. This pictorial review can be used as a handbook to learn the nomenclature and location of the regional lymph nodes for the gastric cancer detected with CT imaging. Knowledge of the CT anatomy of regional lymph nodes allows radiologists to improve the accuracy of the diagnostic conclusions and assess the degree of lymphatic spread of tumor.

рак желудкарегионарные лимфатические узлыкомпьютерная томографияКТ-анатомияgastric cancerregional lymph nodescomputed tomographyCT-anatomyReferencesZhang X.F., Huang C.M., Lu H.S. Surgical treatment and prognosis of gastric cancer in 2613 patients. Wld J. Gastroenterol. 2004; 10 (23): 3405-3408.Zhang X.F., Huang C.M., Lu H.S. Surgical treatment and prognosis of gastric cancer in 2613 patients. Wld J. Gastroenterol. 2004; 10 (23): 3405-3408.Kim A.Y., Kim H.J., Ha H.K. Gastric cancer by multidetector row CT: preoperative staging. Abdom. Imaging. 2005; 30 (4): 465-472.Kim A.Y., Kim H.J., Ha H.K. Gastric cancer by multidetector row CT: preoperative staging. Abdom. Imaging. 2005; 30 (4): 465-472.Kim H.J., Kim A.Y., Oh S.T. et al. Gastric cancer staging at multi-detector row CT gastrography: comparison of transverse and volumetric CT scanning. Radiology. 2005; 236 (3): 879-885.Kim H.J., Kim A.Y., Oh S.T. et al. Gastric cancer staging at multi-detector row CT gastrography: comparison of transverse and volumetric CT scanning. Radiology. 2005; 236 (3): 879-885.Makino T., Fujiwara Y., Takiguchi S. et al. Preoperative T staging of gastric cancer by multi-detector row computed tomography. Surgery. 2011; 149 (5): 672-679.Makino T., Fujiwara Y., Takiguchi S. et al. Preoperative T staging of gastric cancer by multi-detector row computed tomography. Surgery. 2011; 149 (5): 672-679.Hundt W., Braunschweig R., Reiser M. Assessment of gastric cancer: value of breathhold technique and two-phase spiral CT. Eur. Radiol. 1999; 9 (1): 68-72.Hundt W., Braunschweig R., Reiser M. Assessment of gastric cancer: value of breathhold technique and two-phase spiral CT. Eur. Radiol. 1999; 9 (1): 68-72.Hur J., Park M.S., Lee J.H. et al. Diagnostic accuracy of multidetector row computed tomography in T- and N staging of gastric cancer with histopathologic correlation. J. Comput. Assist. Tomogr. 2006; 30 (3): 372-377.Hur J., Park M.S., Lee J.H. et al. Diagnostic accuracy of multidetector row computed tomography in T- and N staging of gastric cancer with histopathologic correlation. J. Comput. Assist. Tomogr. 2006; 30 (3): 372-377.Japanese gastric cancer association. Japanese classification of gastric carcinoma - 3rd English edition. Gastric. Cancer. 2011; 14: 101-112.Japanese gastric cancer association. Japanese classification of gastric carcinoma - 3rd English edition. Gastric. Cancer. 2011; 14: 101-112.Fukuya T., Hiroshi H., Hayashi T. et al. Lymph node metastases: efficacy of detection with helical CT in patients with gastric cancer. Radiology. 1995; 197 (3): 705-711.Fukuya T., Hiroshi H., Hayashi T. et al. Lymph node metastases: efficacy of detection with helical CT in patients with gastric cancer. Radiology. 1995; 197 (3): 705-711.Paramo J.C., Gomez G. Dynamic CT in the preoperative evaluation of patients with gastric cancer: correlation with surgical findings and pathology. Ann. Surg. Oncol. 1999; 6 (4): 379-384.Paramo J.C., Gomez G. Dynamic CT in the preoperative evaluation of patients with gastric cancer: correlation with surgical findings and pathology. Ann. Surg. Oncol. 1999; 6 (4): 379-384.TNM classification of malignant tumors. 7th ed. Sobin L., Gospodarowicz M., Wittekind C. (eds). New York: Wiley, 2009. 336 p.TNM classification of malignant tumors. 7th ed. Sobin L., Gospodarowicz M., Wittekind C. (eds). New York: Wiley, 2009. 336 p.Davydov M.I., Ter-Ovanesov M.D., Abdihakimov A.N., Marchuk V.A. Gastric cancer: preoperative examination and topical aspects of staging. Prakticheskaya onkologiya. 2001; 3 (7): 9-17.Davydov M.I., Ter-Ovanesov M.D., Abdihakimov A.N., Marchuk V.A. Gastric cancer: preoperative examination and topical aspects of staging. Prakticheskaya onkologiya. 2001; 3 (7): 9-17.Kunisaki C., Shimada H., Nomura M. et al. Comparative evaluation of gastric carcinoma staging: Japanese classification versus ne American joint committee on cancer/ International union against cancer classification. Ann. Surg. Oncol. 2004; 11 (2): 203-206.Kunisaki C., Shimada H., Nomura M. et al. Comparative evaluation of gastric carcinoma staging: Japanese classification versus ne American joint committee on cancer/ International union against cancer classification. Ann. Surg. Oncol. 2004; 11 (2): 203-206.Sano T., Aiko T. New Japanese classifications and treatment guidelines for gastric cancer: revision concepts and major revised points. Gastric. Cancer. 2011; 14 (2): 97-100.Sano T., Aiko T. New Japanese classifications and treatment guidelines for gastric cancer: revision concepts and major revised points. Gastric. Cancer. 2011; 14 (2): 97-100.

The authors declare that there are no conflicts of interest present.