PET/MRI在胃癌术前分期的应用及与PET/CT比较研究  

Application of PET/MRI in Preoperative Staging of Gastric Cancer and Compration with PET/CT

作　　者：郑冬 刘怡[3] 刘家金[2] 李科[1] 徐白萱 田嘉禾[2] ZHENG Dong;LIU Yi;LIU Jiajin;LI Ke;XU Baixuan;TIAN Jiahe(Department of Nuclear Medicine,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;不详)

机构地区：[1]战略支援部队特色医学中心放射诊断科,北京100101 [2]解放军总医院第一医学中心核医学科,北京100853 [3]解放军总医院第一医学中心普通外科,北京100853

出　　处：《中国医学影像学杂志》2021年第9期879-884,共6页Chinese Journal of Medical Imaging

基　　金：战略支援部队特色医学中心临床创新探索课题(19ZX34)。

摘　　要：目的探讨~(18)F-FDG PET/MRI在胃癌术前分期中的应用价值,并与PET/CT进行比较研究。资料与方法30例胃癌患者术前行PET/MRI和PET/CT检查,判断TNM分期,以术后病理结果为"金标准",比较两者的诊断效能。结果PET/MRI和PET/CT的T分期准确率分别为76.9%(20/26)、57.7%(15/26)。T1和T4期PET/MRI与PET/CT的敏感度和特异度分别为1.0、0.6和1.0、0.8;受试者工作特征曲线下面积(AUC)T1期分别为1.00与0.78,T2期分别为0.73与0.66,T3期分别为0.72与0.57,T4期分别为0.86与0.83;N分期准确率分别为53.8%(14/26)、34.6%(9/26),两者以上指标差异均无统计学意义(P>0.05)。在N3期,PET/MRI与PET/CT的敏感度分别为0.67、0;两者在N1期AUC比较,差异有统计学意义(0.63比0.53,Z=2.16,P=0.03)。结论PET/MRI在胃癌术前判断TNM分期较PET/CT更为准确,在N分期中更有优势。Purpose To investigate the value of 18F-FDG PET/MRI in preoperative staging of gastric cancer(GC),and to compare PET/MRI with PET/CT.Materials and Methods Thirty patients with GC were retrospectively enrolled and preoperatively performed PET/MRI and PET/CT examinations,determining the tumor-node-metastasis(TNM)stages.The postoperative pathological result was regarded as the gold standard.The diagnostic efficacy was further compared between the two groups.Results The T staging accuracy of PET/MRI and PET/CT were 76.9%(20/26)and 57.7%(15/26),respectively.The sensitivity and specificity of T1 and T4 stages were 1.0 vs.0.6 and 1.0 vs.0.8,respectively.The area under the curve(AUC)of T1 was 1.00 vs.0.78,T2 was 0.73 vs.0.66,T3 was 0.72 vs.0.57,T4 was 0.86 vs.0.83,respectively.The accuracy of N staging was 53.8%(14/26)vs.34.6%(9/26),respectively,and there was no significant difference in N staging between PET/MRI and PET/CT.The sensitivity of N3 stages measured by PET/MRI was 0.67,however,that of PET/CT was 0.There was statistically significant difference in the AUC of N3 stage between two groups(0.63 vs.0.53,Z=2.16,P=0.03).Conclusion PET/MRI is more accurate than PET/CT in preoperative TNM staging of gastric cancer with more advantages especially in N staging.

关 键 词：胃肿瘤 正电子发射断层显像术 磁共振成像 体层摄影术 X线计算机 氟脱氧葡萄糖F18 肿瘤分期 病理学 外科 诊断 鉴别 

分 类 号：R730.44[医药卫生—肿瘤] R735.2[医药卫生—临床医学]