高场磁共振不同序列对胃癌术前分期的临床价值研究

目的:探讨高场磁共振(MRI)不同序列对胃癌术前分期的临床应用价值。方法:应用磁共振扫描仪对48例胃癌患者及20例健康志愿者进行腹部常规MRI平扫。比较MRI常规序列、常规序列结合弥散加重成像(DWI)、常规序列结合DWI与动态增强MRI(DCE-MRI)序列3种检查方法对胃癌患者T分期的准确性和一致性,以术后病理检查结果为金标准。结果:与病理检查结果比较,MRI常规序列、MRI常规序列结合DWI、MRI常规序列结合DWI、DCE-MRI序列诊断胃癌术前分期准确性、敏感度、特异度和Kappa值分别为:72.92%、78.72%、84.63%和0.619,79.17%、79.36%、86.32%和0.707,91.67%、92.74%、98.43%和0.883。结论:MRI常规序列结合DWI、DCE-MRI序列是目前诊断胃癌术前分期准确性最高和最优的MRI检查序列。

The clinical value of high field MRI in preoperative staging of gastric cancer

Objective:To investigate the clinical application value of high field magnetic resonance (MRI) sequences in preoperative staging of gastric cancer.Methods:48 cases of gastric cancer patients and 20 healthy volunteers were examined by routine abdominal MRI scan.Taking pathological reports after operation as gold standards, the accuracy and consistency of T staging of gastric cancer patients were compared among MRI routine sequence,routine sequence combined with DWI,routine sequence combined with DWI and DCE-MRI sequence of three kinds of examination methods.Results:Compared with the results of pathological examination,the accuracy,sensitivity,specificity and Kappa value of MRI routine sequence,MRI routine sequence with DWI,MRI routine sequence combined with DWI and DCE-MRI sequence in diagnosis of gastric cancer were 72.92%,78.72%,84.63% and 0.619,79.17%,79.36%,86.32% and 0.707,91.67%,92.74%、98.43% and 0.883,respectively.Conclusion:MRI routine sequence combined with DWI and DCE-MRI sequences is the most accurate and optimal MRI examination sequence for the diagnosis of gastric cancer preoperative staging.