Objective   To investigate the clinical guidance value of 64-slice spiral computed tomography (CT) in patients who need undergo D2 lymph node dissection for advanced gastric carcinoma.    Methods    Fifteen patients with advanced gastric carcinoma who received plain and contrast scanning of CT

and 15 matched patients who did not get this examination were subjected in this study. They all received D2 lymph node dissection. CT data

the amount of lymph nodes detected by CT preoperatively and the diameter of lymph nodes were analyzed. The number of lymph nodes and metastasis rate of lymph nodes at different diameter were studied.    Results   More lymph nodes were detected by 64-slice spiral CT

especially for the lymph nodes with diameter lesser then 10 mm. The detection rates of lymph nodes by CT were  89.5% (111/124) for those 10 mm in diameter

65.3% (81/124) for those between 3 mm to 5 mm

and 32.3% (40/124) for those 3 mm

respectively. Average excisional lymph nodes were 32 in CT group. The metastasis rates of lymph nodes with diameter 10 mm

between 3 mm to 5 mm and 3 mm were 77.7% (108/139)

49.0% (68/139)

18.0% (25/139) respectively. Average excisional lymph nodes was 19 in control group. The metastasis rates of lymph nodes with diameter 10 mm

between 3 mm to 5 mm and 3 mm were 52.1% (25/48)

27.1% (13/48)

8.3% (4/48) respectively.    Conclusion   64-slice CT detects more small lymph nodes preoperatively for advanced gastric cancer patients.