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动态磁共振减影技术对胃癌术前TNM分期的诊断价值
引用本文:吴建国,方国恩,罗天航,张峰.动态磁共振减影技术对胃癌术前TNM分期的诊断价值[J].中华胃肠外科杂志,2008,11(6).
作者姓名:吴建国  方国恩  罗天航  张峰
作者单位:1. 第二军医大学长海医院普通外科,上海,200433
2. 第二军医大学长海医院影像科,上海,200433
摘    要:目的 探讨动态磁共振(MRI)减影技术在胃癌术前TNM分期评估中的临床应用价值.方法 运用动态MRI减影技术,对39例胃癌患者进行术前TNM分期诊断.患者术后经病理确诊.将MRI结果与术后病理结果对比.结果 动态MRI对本组胃癌浸润深度(T)的总体诊断准确率为82.1%;对淋巴结转移状况(N)的总体诊断准确率为71.8%;对远处转移(M)的总体诊断准确率为84.6%:TNM分期诊断总的准确率为71.8%.MRI对胃癌术前TNM分期的诊断与术后病理结果有着较高的一致性(Kappa值为0.671~0.763,P<0.05).结论 MRI在显示胃癌侵犯胃壁的深度、淋巴结转移及远处脏器转移方面起着重要的作用,对于胃癌术前临床分期的评估有其独特的优越性.

关 键 词:胃肿瘤  磁共振成像  肿瘤分期

Value of dynamic subtraction technique of magnetic resonance imaging in preoperative TNM-staging assessment of gastric carcinoma
WU Jian-guo,FANG Guo-en,LUO Tian-hang,ZHANG Feng.Value of dynamic subtraction technique of magnetic resonance imaging in preoperative TNM-staging assessment of gastric carcinoma[J].Chinese Journal of Gastrointestinal Surgery,2008,11(6).
Authors:WU Jian-guo  FANG Guo-en  LUO Tian-hang  ZHANG Feng
Abstract:Objective To explore the value of dynamic subtraction technique of magnetic resonance imaging MRI in preoperative TNM-staging assessment of gastric carcinoma. Methods MRI was performed in 39 patients with gastric carcinoma diagnosed by postoperative pathology.The results of MRI were prospectively analyzed by one professor and compared with the corresponding pathological findings. Results In comparison with pathological results, the accuracy of MRI for T stage was 82.1%, for N stage was 71.8%, and for M stage was 84.6% respectively. The accuracy of MRI for TNM stage was 71.8%, which revealed concordance between the preoperative TNM-staging and postoperative pathological findings (Kappa=0.671-0.763, P<0.05). Conclusion MRI plays an important role in the assessment of invasion depth of gastric carcinoma, lymph node and distant organ metastases, which has unique priority in preoperative TNM-staging assessment of gastric carcinoma.
Keywords:Stomach neoplasms  Magnetic resonance imaging  Neoplasms staging
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