3．0T MR弥散加权成像在贲门癌T分期中的应用  

Application of diffusion-weighted imaging on 3.0T MR in T staging of cardia cancer

作　　者：刘松[1] 何健[1] 管文贤[2] 李强[2] 周竹萍[1] 俞海平[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,江苏南京210008 [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7期1091-1093,1097,共4页Journal of Practical Radiology

基　　金：基金项目：江苏省自然科学基金项目（BK2012531）;南京市医学科技发展基金（2012001）;南京市卫生青年人才培养工程（第三层次）.

摘　　要：目的探讨3．0TMR弥散加权成像（DWI）在贲门癌诊断及T分期中的应用价值。方法2名观察者分别独立分析31例贲门癌患者术前MRT2WI、DWI和增强图像，对肿瘤进行检测和分期，并与手术病理进行对照。结果DWI检测到了所有贲门癌病灶，1例病灶在T：wI和增强图像未能发现。总体T分期准确率比较中，DWI（80．6％）显著高于T。WI（58．1％）（P=0．039），DWI与增强图像无显著性差异（P=0．727）。DWI观察者间一致性（Kappa=0．811）优于增强（Kappa=0．640）和T2WI（Kappa=0．555）。结论DWI在贲门癌T分期中的准确率显著高于T2wI，在某些情况下有望替代MR增强扫描。Objective To evaluate the application of diffusion-weighted imaging{DWI） on 3.0T MR in preoperative diagnosis and T staging of cardia cancer. Methods Two radiologists interpreted preoperative T2 WI,DWI and contrast-enhancement （CE} MR ima- ging of 31 patients with cardia cancers independently. The lesions were detected and staged, with the reference of post-operative his- topathological findings. Results All the eardia cancers were detected in DWI, while one lesion was missed in both T2WI and CE MRI. Overall T staging accuracy in DWI was significantly higher than that in TeWI {80.6% vs 58.1 % ,P=0. 039）, while there was no significant difference between DWI and CE MRI （P 0.727）. DWI （Kappa=0.811} had a better interobserver agreement than CE MRI（Kappa--0.640} and T2WI （Kappa=0. 555）. Conclusion DWIis superior toT2WlinT staging accuracy of cardia canc- ers, and has the potential to replace CE MRI in some cases.

关 键 词：弥散加权成像 磁共振成像 贲门癌 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]