MR弥散加权成像在进展期胃癌T分期中的应用  

Application of MR diffusion-weighted imaging in tstaging of advanced gastric cancer

作　　者：刘松[1] 何健[1] 管文贤[2] 李强[1] 俞海平[1] 周竹萍[1] 包善华[2] 周正扬[1] 

机构地区：[1]南京医科大学鼓楼临床医学院医学影像科 [2]南京医科大学鼓楼临床医学院普外科,江苏南京210008

出　　处：《实用放射学杂志》2013年第4期565-568,共4页Journal of Practical Radiology

基　　金：基金项目：江苏省自然科学基金（BK2012531）;南京市医学科技发展基金（2012001）;南京市医学科技发展青年启动项目（yqklll59）.

摘　　要：摘要：目的探讨MR弥散加权成像（DWI）在进展期胃癌诊断及T分期中的应用价值。方法2名观察者分别独立分析41例进展期胃癌患者术前MRT。wI和DWI图像，对肿瘤进行检测和分期，并与手术病理进行对照。结果TzwI和DWI图像均检测到了所有进展期胃癌病灶。全部病灶在DWI图像上均呈显著高信号。DWI总体分期准确率（85．4％）显著高于TzWI（65．9％）（P一0．008），DWI对T3期病灶的分期准确率（83．3％）亦显著高于T2WI（62．5％）（P一0．031）。DWI观察者间一致性（Kappa。0．839）优于T2WI（Kappa一0．603）。结论与T2wI相比，DWI对进展期胃癌的分期准确率显著提高，尤其对T3期病灶。DWI观察者间一致性明显优于T2wI。Objective To evaluate the application of MR diffusion-weighted imaging（DWI） in preoperative diagnosis and T stag- ing of advanced gastric cancer. Methods Two radiologists interpreted preoperative T^WI and DWI images of 41 patients with ad- vanced gastric cancers independently. The lesions were detected and staged, with the reference of post-operative histopathological findings. Results All the advanced gastric cancers were detected in both T2 WI and DWI images. All the lesions showed remarkable hyperintense in DWI images. Overall staging accuracy of DWI was significantly higher than that of T2WI 185.4~ vs 65.9~, P： 0. 008）. Staging accuracy of pT3 gastric cancers in DWI was also significantly higher than that in TzWI （83.3~ vs 62.5~, P~ 0. 031）. DWI had a better interobserver agreement than T2WI （Kappa^O. 839, 0. 603, respectively）. Conclusion DWI is superior to TzWI in T staging accuracy of advanced gastric cancers, especially in stage T3 lesions. Additionally, DWI has a better interob- server agreement than T2 WI.

关 键 词：弥散加权成像 磁共振成像 进展期胃癌 分期 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.2[医药卫生—诊断学]