磁共振成像和多层螺旋CT对胃癌术前分期的比较研究

目的 探讨磁共振成像（magnetic resonance imaging,MRI）和多层螺旋CT（multi-slice spiral CT,MSCT）对胃癌术前分期的价值.方法 对27例经胃镜活检证实的胃癌患者术前行磁共振成像和多层螺旋CT检查,并与术后病理检查结果对照.结果 MRI和MSCT对胃癌T分期的判断准确率分别为81.5%（T1100%,T2 57.1%,T3 81.8%,T4 100%）和77.8%（T1 100%,T2 57.1%,T3 72.7%,T4 100%）,差别无统计学意义（P〉0.05）.MRI和MSCT对胃癌N分期的判断准确率分别为63.6%（N077.8%,N160.0%,N2 50.0%）和72.7%（N066.7%,N180.0%,N2 75.0%）,尽管二者无显著差异（P〉0.05）,但MSCT对胃癌N分期的判断准确率和对淋巴结转移的敏感性稍高于MRI.MRI对胃癌M分期的判断准确率与MSCT基本一致,同时,MRI和MSCT对胃癌TNM分期的总体判断准确率无显著差异（P〉0.05）.结论 MRI由于其对胃癌术前N分期的局限性目前尚不能完全取代MSCT在胃癌术前分期中的应用.

A comparative study of magnetic resonance imaging and multi-slice spiral CT in preoperative staging of gastric carcinoma

Objective] To investigate the value of magnetic resonance imaging (MRI) and multi-slice spiral CT (MSCT) in preoperative staging of gastric carcinoma. Methods] MRI and MSCT were performed in 27 patients with gastric carcinoma proved by means of biopsy, and the results were compared with postoperative pathologic findings. Results] The accuracy of MRI and MSCT in T staging was 81.5% (T1 100%, T2 57.1%, T3 81.8%, T4 100%, respectively) and 77.8% (T1 100%, T2 57.1%, T3 72.7%, T4 100%, respectively), respectively, and there was no statistical difference (P >0.05). The accuracy of MRI and MSCT in N staging was 63.6% (N0 77.8%, N1 60.0%, N2 50.0%, respectively) and 72.7% (N0 66.7%, N1 80.0%, N2 75.0%, respectively), respectively. Although there was no statistical difference(P >0.05), the accuracy for N staging and the sensitivity for lymph node metastasis with MSCT were slightly higher than those with MRI. The accuracy of MRI in M staging was equal to that of MSCT. In addition, there was no statistical difference between MRI and MSCT in the overall accuracy of TNM staging (P >0.05). Conclusion] MRI cannot replace MSCT in preoperative staging of gastric carcinoma because of its limitation in N staging.