胃癌根治术后胃左动脉旁淋巴结在螺旋CT中的定位孙效益1赵园园1*周岩冰2何信佳1周锐志3于丽1张碧媛1安永恒1山东青岛266003（青岛大学医学院附属医院1肿瘤科；2普外科；3影像科；*为通讯作者）【摘要】目的：测量并确定胃左动脉旁淋巴结在螺旋CT中的区域范围，指导胃癌根治术后放疗靶区的勾画。方法：对36例胃癌患者手术时在胃左动脉根部放置钛夹。螺旋CT下采取放疗体位行三期增强扫描、冠状位及矢状位重建，以T12椎体为参考点，测量胃左动脉旁淋巴结的三维方向，应用SPSS17.0统计学软件计算分析其分布，测算胃左动脉旁淋巴结根部所在位置的变异范围。结果：Kolmogorov-Smirnov检验显示，全组在各边界近似服从正态分布，男、女在胃左动脉旁淋巴结的分布趋势上是一致的。Pearson分析显示，胃左动脉旁淋巴结的边界与年龄、身高、体重、椎体高、椎体宽无相关性。男、女胃左动脉旁淋巴结的前界分别为垂直于T12椎体最前缘切线46.56±1.95、37.56±2.35mm；后界分别为17.50±2.02、16.44±2.34mm；左界分别为距T12椎体左缘右22.48±2.04、16.03±2.25mm；右界分别为距T12椎体左缘左14.33±2.12、5.53±2.35mm；上界分别为距T12椎体上缘上26.89±2.12、16.09±2.30mm；下界分别为距T12椎体下缘下9.58±2.13、8.58±2.36mm。结论：采用新的标记方法以及新的影像学技术可取得更准确的胃左动脉旁淋巴结的定位统计结果。要完全证实胃左动脉旁淋巴结的分布区域符合正态分布还需要进一步扩大病例数。在目前条件下，定位胃左动脉旁淋巴结可参考本文结果。【关键词】胃肿瘤；淋巴结；外科手术器械；计算机断层扫描；分布中图分类号R735.2文献标志码ALeftgastricarterylymphnodeafterradicaloperationofgastriccancerlocalizationinthespiralComputerTomography（CT）SunXiao-yi*，ZhaoYuan-yuan，ZhouYan-bing，HeXin-Jia，ZhouRui-zhi，YuLi，ZhangBi-yuan，AnYong-heng.*DepartmentofOncology，TheAffiliatedHospitalofQingdaoUniversityMedicalCollege，Qingdao，266003，P.R.China【Abstract】Objective：Tomeasureanddefinetheregion-wideofleftgastricarterylymphnodes,toguideradiotherapytargetvolumedelineationafterradicaloperationofgastriccancer.Methods：Titaniumclipsweresetaroundtherootleftgastricarteryin36patientswithgastriccarcinomaatthetimeofsurgery.UnderthespiralComputerTomography(CT),enhancementscanningweretakenintheradio-therapeuticposition,thecoronalviewandsagittalviewwerereconstituted.Then,T12vertebralbodyasreferencepoint,measurementofleftgastricarterylymphnodesinthethree-dimensionaldirection.WithSPSS17.0software,rangeofvariationoflocalizationoftherootofleftgastricarterylymphnodeswereobtained.Results：AccordingtotheanalysisofKolmogorov-Smirnovtest,eachborderwasofapproximatenormaldistribution,Maleandfemalegroupsintheleftgastricarterylymphnodesonthedistributionofthetrendisconsistent.PearsonCorrelationCoefficientsanalysisdidnotsuggestasignificantrelationshipbetweentheborderandage,heigh