Multidetector CT assessment of postgastrectomy patients.
OBJECTIVE
To assess the usefulness of multidetector CT (MDCT) with multiplanar reconstructions (MPR) and 3D reconstruction software, in the follow-up of patients who underwent gastrectomy for gastric carcinoma.


METHODS
From April 2001 to March 2003, 25 patients (16 males and 9 females) aged between 40 and 70 years (55 years on average) were assessed after gastric resection for gastric carcinoma. All patients underwent chest-abdominal MDCT and esophago-gastro-duodenoscopy (EGD). A biopsy was performed on 11 patients. All patients were examined after achieving gastric wall distension by administering 2 sachets of negative contrast agents, before and after intravenous injection of water-soluble contrast medium (2 ml for kg) at a flow-rate of 3-4 of ml/sec.


RESULTS
CT demonstrated the absence of disease in 15 cases, tumour recurrence in 9 cases, associated with liver metastases in one case and lymphadenopathy in one case. All lesions were recognizable in the axial scans. MPR improved the visualization of the longitudinal extension of lesions and the 3D reconstructions were of assistance in the study of the inner surface of the anastomotic loops. EGD showed absence of disease in 15 cases, tumour recurrence in 9 cases and congested mucosa with small areas of superficial ulceration in one case, found at biopsy to be secondary to gastritis, in one case.


CONCLUSIONS
MDCT with MPR and 3D reconstructions should be regarded as a promising method for the postoperative follow-up of patients after gastrectomy. This method is useful to demonstrate recurrences at the site of anastomosis, lymph node metastases or distant metastases, even if it cannot as yet replace traditional endoscopy.
Quarticelli
Teresa
T
DiMIMP-Sezione di Diagnostica per Immagini, Ospedale Consorziale Policlinico, Università degli Studi, Bari. terquar@hotmail.com
Scardapane
Arnaldo
A
Memeo
Maurizio
M
Calbi
Roberto
R
Stabile Ianora
Amato Antonio
AA
Angelelli
Giuseppe
G
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed