복부 전산화촬영에 있어 Valsalva Manuever를 이용한 위암진단의 유용성

CT Abdomen Valsalva Method for Stomach Cancer

Purpose As the stomach lies adjacent to the pancreas, it is clinically important to detect metastasis of stomach cancer to the pancreas in the early stages. The metastasis to the pancreas can be the most important factor in the determining difficulty of the stomach cancer treatment. In our hospital, the valsalva maneuver is performed in order to diagnose more accurately the metastasis of stomach cancer to the pancreas, and thereby increasing the accuracy of progressive stomach cancer diagnosis. This method is carried out in the more cornforlE supine position in order to separate the pancreas from the stomach by increasing the pressure in the abdominal cavity. Materials & Methods Used materials CT scanner: Siemens MD-CT Sensationl6 C-M flow rate: 3ml/sec,2cc/kg(use bolus tracking) Exposure condition: 120kvp, 140Effective mAs 0.75Detector collimation, 3mm thickness 12mm Feed/Rotation(pitch:1) Kernel value: B31f medium smooth+ Window width,level: 350, 40 Reading: D.R Dr Subjects and Methods: An endoscopy was performed on patients with stomach cancer and patients suspected of stomach cancer in our hospital. Those found with a carcinoma were designated as the subjects, and a CT Abdomen scan was performed in order to determine the metastasis. For five months starting from Oct. 1, 2004 to Feb. 28, 2005, these 80 subjects were then separatedinto two groups, of which 40 patients were subjected to CT Prone scan (water) and 40 patients were subjected to CT Supine scan (valsalva), and then compared. Of the 80 patients, 57 patients were male, 23 patients were female, and 6 patients were in there twenties, 23 in their thirties, 38 in their forties, and 13 patients were in their fifties and up. subjects:The stomach ca patient who is inspected the endoscope From Oct. 2004 to Feb. 2005 we designated 80 patients who is inspected the endoscope and it shared in 2 group(each 40 patients) Patient scan method: Odd day CT Prone scan(water). 40case Even day CT Supine scan (valsalva). 40case Results From the CT Prone scan (water) group, 22 cases had satisfactory and 18 cases had indefinite results in organ separation. From the Supine scan (valsalva), 36 cases had satisfactory and 4 cases had indefinite results m organ separation. Conclusion From this study, it was found that patients in supine position could breathe more stably than the patients in the prone position, and therefore, difficulty in breathing could be prevented. Most importantly, it can be concluded that use of the valsalva method has better results in detecting metastasis of stomach cancer to the pancreas than the existing prone method. Therefore, the valsalva maneuver can replace the existing prone method when performing a CT scan on a stomach cancer patient in the future.