3.0T磁共振弥散加权成像在进展期胃癌中的应用  

Application of 3.0T magnetic resonance diffusion weighted imaging in the advanced gastric cancer

作　　者：王丹丹[1] 卢增新[1] 赵振华[1] 孙爱静[1] 陶锋[1] 吕杰青[1] 

机构地区：[1]浙江省绍兴市人民医院浙江大学绍兴医院放射科,浙江绍兴312000

出　　处：《医学影像学杂志》2016年第4期678-682,共5页Journal of Medical Imaging

基　　金：浙江省卫生厅一般研究计划项目(编号:2013KYB263)

摘　　要：目的探讨3.0T磁共振(MRI)弥散加权成像(DWI)在进展期胃癌中的临床应用价值。方法对经超声胃镜及病理确诊的60例进展期胃癌患者进行3.0T MRI DWI检查,分析DWI对胃癌病灶、胃周淋巴结的显示能力,通过测量正常胃壁与肿瘤累及区域的ADC值比较两者之间的差异性。结果 60例患者通过磁共振弥散加权成像检查能很好的显示胃癌病灶、胃周肿大淋巴结,癌肿和胃周淋巴结在DWI像上均呈明显的高信号,癌肿平均ADC值为1.444±0.029×10^(-3)mm^2/s,淋巴结平均ADC值为1.375±0.205×10^(-3)mm^2/s,正常胃壁表现为低信号,平均ADC值为2.088±0.194×10-3mm^2/s,与前二者具有显著差异(P<0.001)。60例中有32例进行了新辅助化疗,化疗后癌肿的ADC值升高,平均1.572±0.261×10^(-3)mm^2/s,与化疗前比较有显著的统计学差异(P<0.001)。结论 MRI DWI检查可有效的检测进展期胃癌肿瘤累及范围和胃周淋巴结肿大情况,通过比较胃癌新辅助化疗前后的ADC值能有效地评价其治疗疗效。Objective To explore the the clinical application value of 3. 0 T magnetic resonance imaging（ MRI） diffusion weighted imaging（ DWI） in advanced gastric cancer. Methods 60 patients with advanced gastric cancer confirmed by ultrasonic gastroscopy and pathology underwent 3. 0 T MRI DWI examination. The displaying ability of DWI for gastric cancer lesions and lymph nodes around the stomach was analyzed. By measuring the normal stomach and tumor involving the area of the ADC values,we compared the differences between the two parameters. Results MRI DWI was able to display the focal area of gastric cancer,swollen lymph nodes around the stomach in all 60 patients,which obviously showed high signal. The mean ADC value of cancer was 1. 444 ± 0. 029 × 10^-3mm^2/ s,the average ADC value of lymph node was 1. 375 ± 0. 205 × 10^-3mm^2/ s. The normal stomach wall exhibited low signal,the average ADC value of normal stomach was 2. 088 ± 0. 194 × 10-3mm2/ s,with significant difference compared with and the former two parameters（ P〈0. 001）. After chemotherapy,the tumor ADC value increased and the tumor ADC value was 1. 572 ± 0. 261 × 10^-3mm^2/ s,showing statistical significant difference compared with that before treatment（ P〈0. 001）. Conclusion MRI DWI examination can effectively detect the status of the affected the scope and stomach and lymph node enlargement in patients with advanced stomach cancer. By comparing ADC values before and after new adjuvant chemotherapy for gastric carcinoma,we can effectively evaluate its curative effect.

关 键 词：进展期胃癌 磁共振成像 弥散 ADC值 

分 类 号：R735.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]