摘要多学科诊疗模式对胃癌的影像学评价提出了更高要求，涵盖从分期到评效的多个层面。受到分辨率制约，目前各种影像学手段均无法显示胃的浆膜结构，联合浆膜面“亮线征”或可间接提高胃癌侵出浆膜的判断准确率；能谱CT和磁共振扩散加权成像则可能为胃癌的分期评价提供具有潜力的新手段。胃癌CT评价时，应重视癌肿在脂肪间隙内弥散浸润并广泛侵犯周围脏器所导致的不可切除征象。评价腹膜转移时要注意观察位置的全面性，并关注一些可能提示腹膜转移的早期征象。磁共振扩散加权成像可能为胃癌放化疗的疗效评价提供新的指标，辅助解决胃癌新辅助化疗无合适形态学靶病灶的问题。

abstractsThe popularization of the multidisciplinary treatment has brought more demands to the radiological evaluation of the gastric cancer, which includes staging and response evaluation. Limited by the resolution, the present imaging modalities can not demonstrate tiny structures of the serosa, and the employment of the hyperattenuating serosa sign may improve the diagnostic performance of T4a. The spectral CT and diffusion weighted MRI may provide new potential methods for the staging of gastric cancer. Attention should be paid to the unresectable signs caused by the dispersed infiltration of adjacent fat space to the organs. The comprehensive evaluation of peritoneal metastasis should base on the sites and early signs. Diffusion weighted MRI may provide new indicator for the response evaluation of gastric cancer to neoadjuvant chemotherapy.