目的 研究螺旋CT血管成像(CTA)和灌注成像(CTPI)对胃癌血供和血流动力学评价及意义。方法 选取经病理检查确诊的胃癌患者88例，其中63例采用体部灌注扫描序列行灌注扫描，分析血容量( BV) 、血流量( BF) 、表面通透性( PS)、平均通过时间( MTT)与胃癌局部分化、侵袭的相关性。27例患者行动态增强扫描，分析胃癌的位置及供血血管。结果 27例增强扫描患者中20 例肝固有动脉、腹腔干、胃网膜右动脉、胃左右动脉应用容积再现( VR)可清晰显示，最大密度投影( MIP) 显示细小血管，胃癌血供与肿瘤生长位置有密切关系，胃癌血管基本来自胃自身血管，BV、BF、PS、MTT 与T 分期差异有统计学意义（P＜0.05）； 中高分化组与低分化组PS 差异有统计学意义（P＜0.05），与BF、BV、PS、MTT 无明显相关（P＞0.05）。结论 螺旋CTA 能够清晰显像胃部肿瘤的血管及血供，提供了肿瘤与血管关系的观察，CTPI 可显示胃癌局部分化、侵袭程度。

Objective To evaluation clinical significance of CTA and CTPI in the blood supply and hemodynamic of gastric cancer. Methods 88 patients with gastric cancer were selected in this study. 63 patients were scanned by perfusion CT, and the relationship of blood flow (BF), blood volume (BV), permeability surface (PS) and mean transit time (MTT) with local invasion of gastric cancer and differentiation were analyzed. 27 cases received dynamic enhanced scanning and the location of the stomach arterial blood vessels and cancer were analyzed. Results 20 patients in 27 cases of underwent dynamic enhanced scanning clearly displayed the proper hepatic artery, celiac axis, left and right gastric artery and right gastroepiploic artery on the VR. MIP showed that the small blood vessels and stomach blood supply was related to the location of the tumor growth. The blood vessels that supply the gastric cancer were largely from their own blood vessels of the stomach. There was significant difference in BV, BF, PS, MTT and T staging. MTT could reflect the general classification of gastric cancer histological characteristics. There was significant difference of PS in middle and high differentiated group compared with poorly differentiated group. PS had no significant correlation with BF, BV and MTT. Conclusion CTA could clearly display the stomach tumor and blood supply, and CTPI can reflect local invasion and differentiation degree of gastric cancer to some extent.