磁共振成像和多层螺旋计算机成像在贲门癌术前T分期中的比较研究  

Comparison of magnetic resonance with multislice computer tomography in T-staging of cardiac cancer

作　　者：潘自来[1] 张欢[1] 杜联军[1] 凌华威[1] 宋琦[1] 陈克敏[1] 

机构地区：[1]上海第二医科大学附属瑞金医院放射科,200025

出　　处：《中华消化杂志》2004年第8期459-463,共5页Chinese Journal of Digestion

基　　金：上海自然科学基金赞助 ( 0 1ZB14 0 44 )

摘　　要：目的　通过磁共振扫描 (MR)、多层螺旋CT(MSCT)检查对贲门癌术前T分期进行前瞻性比较 ,并与病理结果对照 ,探讨MR与MSCT在贲门癌术前T分期中的价值。方法　 2 8例经活检证实的贲门癌患者 ,于术前 1周内行MR和MSCT检查 ,术后将病理与两者结果相比较。MR扫描序列包括FSET1W ,FSET2W ,FSET1W加脂肪抑制以及动态FSPGR加脂肪抑制扫描 ,MSCT扫描为平扫后作动态三期增强。结果　MR、MSCT对胃癌浸润深度 (T)判断与手术病理比较的准确率分别为T188.8%和 11.1% ;T2 77.8%和 2 2 .2 % ;T383.3%和 32 .7% ;T4 10 0 .0 %和 5 0 .0 %。与MSCT相比较 ,MR动态增强加脂肪抑制以及延迟扫描对早期病变的显示、T2与T3、T3与T4的区分以及食管和主动脉侵犯方面均有优势 (P <0 .0 5 )。在平扫序列中 ,T1W加脂肪抑制能较好地显示肿瘤特征、溃疡存在以及周围淋巴结肿大。统计分析显示 ,MR在贲门癌T分期的诊断准确性明显高于MSCT。结论　MR在贲门癌T分期中有较大的优势 ,可用于指导选择正确的治疗方案 ,避免不必要的手术。Objective To compare the diagnostic accuracy of magnetic resonance (MR) images with multislice computer tomography (MSCT) for preoperative T-staging of patients with cardiac cancer. Methods MR and MSCT were performed in 28 cases of cardiac cancer diagnosed by biopsy prior to operation within one week. After an oral intake of 1000 ml water and an injection of hypotonic agent, MR and MSCT scan were carried out. MR sequences included FSE T1W, FSE T2W, FSE T1W with fat suppression and dynamic enhanced FSPGR with fat suppression. MSCT was applied with dynamic triphasic contrast enhancement. All of the findings were prospectively analyzed by two doctors separately and compared with the surgical and pathological findings. Results According to histopathologic staging, the accuracy of MR and MSCT in T1-staging were 88.8% and 11.1%, in T2-staging were 77.8% and 22.2%, in T3-staging were 83.3% and 32.7%, in T4-staging were 100.0% and 50.0%, respectively. Dynamic enhanced and delayed MR with fat suppression was superior to MSCT for revealing the involvement of esophagus and aorta, early stage of invasiveness and providing more evidences in T2 to T3 or T3 to T4 staging (P<0.05). Among MR plain scan sequences, T1W with fat suppression was outstanding in depicting the gross features of the tumor, presence of ulceration, and adjacent lymph node swelling. Diagnostic accuracy of MR was marginally higher than that of MSCT in T-staging of cardiac cancer. Conclusion MR is superior to MSCT in T-staging of cardiac cancer and can be used to optimize the therapeutic strategy and avoid unnecessary operation.

关 键 词：磁共振成像 多层螺旋计算机成像 贲门癌 T分期 MSCT 

分 类 号：R735.2[医药卫生—肿瘤]