MRI联合不同扫描序列在胃癌术前分期诊断及化疗效果和预后的评估  

Application of conventional MRI combined with different scanning sequences in preoperative staging diagnosis,chemotherapy efficacy and prognosis evaluation of gastric cancer

作　　者：钟广俊[1] 刘春华[1] 朱万森[1] 徐晓雷[1] 王兆军[1] Guangjun Zhong;Chunhua Liu;Wansen Zhu;Xiaolei Xu;Zhaojun Wang(Department of Gastrointestinal Surgery,Baoying County People′s Hospital of Jiangsu Province,Baoying 225800,China)

机构地区：[1]江苏省宝应县人民医院胃肠外科,225800

出　　处：《中华消化病与影像杂志（电子版）》2023年第6期378-382,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：扬州市科技计划项目(YZ2021090)。

摘　　要：目的观察常规MRI联合不同扫描序列在胃癌术前分期诊断及化疗效果、预后评估中的应用价值。方法选取2022年3月至2023年3月江苏省宝应县人民医院收治的82例胃癌患者为研究对象,均接受常规MRI联合不同扫描序列检查根据患者化疗效果分为有效组及无效组,根据患者预后分为转移组和未转移组。以术后病理结果为金标准,评估其对胃癌术前分期和化疗效果及预后的评估价值。结果常规MRI联合不同扫描序列诊断胃癌术前分期的准确率为89.02%(73/82)。有效组T2WI混杂高信号占比、肿瘤大小、ADC值明显低于无效组,转移组则明显高于未转移组(P<0.05)。T2WI混杂高信号占比、肿瘤大小、ADC值是胃癌患者化疗效果预后的独立影响因素(P<0.05)。常规MRI联合不同扫描序列检查的四项指标联合预测患者化疗效果的ROC曲线下面积为0.857,敏感性75.0%,特异性88.3%,95%CI0.797~0.904;预测患者预后的ROC曲线下面积为0.812,敏感性75.56%,特异性72.39%,95%CI0.755~0.861。结论常规MRI联合不同扫描序列对胃癌术前分期诊断的准确率较高,同时可评估患者化疗效果和预后。Objective To observe the application value of conventional MRI combined with different scanning sequences in preoperative staging diagnosis,chemotherapy efficacy and prognosis evaluation of gastric cancer.Methods A total of 82 gastric cancer patients admitted to Baoying County People′s Hospital of Jiangsu Province from March 2022 to March 2023 were selected as the study subjects.All patients were examined with conventional MRI combined with different scanning sequences.They were divided into the effective group and the ineffective group based on the efficacy of chemotherapy.According to the prognosis,the patients were divided into metastasis group and non-metastasis group.Postoperative pathological results were taken as the golden standard to analyze the value of conventional MRI combined with different scanning sequences in preoperative staging diagnosis,chemotherapy efficacy and prognosis evaluation of gastric cancer.Results The accuracy of conventional MRI combined with different scanning sequences in preoperative staging diagnosis of gastric cancer was 89.02%(73/82).The proportion of mixed high signal on T2WI,tumor size,and ADC value were significantly lower in the effective group than those in the ineffective group,and significantly higher in the metastasis group than those in the non-metastasis group(P<0.05).The proportion of mixed high signal on T2WI,tumor size,and ADC value were independent influencing factors for the efficacy and prognosis of chemotherapy in gastric cancer patients(P<0.05).The area under the ROC curve of conventional MRI combined with four different scanning sequences for predicting the efficacy of chemotherapy was 0.857.The sensitivity and specificity were 75.0%and 88.3%(95%CI:0.797-0.904).The area under the ROC curve for predicting the prognosis was 0.812.The sensitivity and specificity were 75.56%and 72.39%(95%CI:0.755-0.861).Conclusion Conventional MRI combined with different scanning sequences is relatively accurate in preoperative staging diagnosis of gastric cancer.In addition,i

关 键 词：胃癌 磁共振成像 肿瘤分期 化学治疗 预后 

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