MRI弥散加权成像与表观弥散系数对胃癌T分期的诊断价值  

Diagnostic value of MRI diffusion weighted imaging and apparent diffusion coefficient in T staging of gastric cancer

作　　者：张玮 尉轶旻 庞瑜丹 陈宏 ZHANG Wei;WEI Yimin;PANG Yudan;CHEN Hong(Department of Radiology,Jing’an Branch of Huashan Hospital Affiliated to Fudan University/Shanghai Jing’an District Central Hospital,Shanghai 200040,China;MRI Room,Jing’an Branch of Huashan Hospital Affiliated to Fudan University/Shanghai Jing’an District Central Hospital,Shanghai 200040,China;Department of General Surgery,Jing’an Branch of Huashan Hospital Affiliated to Fudan University/Shanghai Jing’an District Central Hospital,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院静安分院/上海市静安区中心医院放射科,上海200040 [2]复旦大学附属华山医院静安分院/上海市静安区中心医院核磁共振室,上海200040 [3]复旦大学附属华山医院静安分院/上海市静安区中心医院普外科,上海200040

出　　处：《癌症进展》2024年第8期910-913,共4页Oncology Progress

摘　　要：目的探讨MRI弥散加权成像(DWI)和表观弥散系数(ADC)对胃癌T分期的诊断价值。方法86例胃癌患者均进行MRI检查,以病理检查结果作为诊断金标准,分析DWI和ADC值对胃癌T分期的诊断价值。结果ADC值诊断胃癌T分期的准确度为80.23%(69/86),Kappa值=0.704;DWI诊断胃癌T分期的准确度为81.40%(70/86),Kappa值为0.727;ADC值联合DWI诊断胃癌T分期的准确度为91.86%(79/86),高于ADC值和DWI单独检查,Kappa值为0.878。T_(1~2)期胃癌患者的ADC值为(1.17±0.23)×10^(-3) mm^(2)/s,明显高于T_(3~4)期患者的(0.83±0.14)×10^(-3) mm^(2)/s,差异有统计学意义(P﹤0.01)。ADC值、DWI信号强度、f值联合检查对胃癌T分期的诊断价值优于三者单独检查。结论ADC值联合DWI可为胃癌T分期的诊断提供一定临床依据,但ADC值因受多种因素影响,对胃癌T分期之间的区分具有一定局限性。Objective To investigate the diagnostic value of MRI diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)in T staging of gastric cancer.Method MRI were performed in 86 patients with gastric cancer.The diagnostic value of DWI and ADC in T staging of gastric cancer were analyzed by pathological result as the diagnostic gold standard.Result The accuracy of ADC value in diagnosing T stage of gastric cancer was 80.23%(69/86),and Kappa value was 0.704.The accuracy of DWI in diagnosing T stage of gastric cancer was 81.40%(70/86),and Kappa value was 0.727.The accuracy of ADC value combined with DWI in diagnosing T stage of gastric cancer was 91.86%(79/86),higher than those of ADC value and DWI single examination,and Kappa=0.878.The ADC value in patients with stage T_(1-2) was(1.17±0.23)×10^(-3) mm^(2)/s,which was significantly higher than(0.83±0.14)×10^(-3) mm^(2)/s in patients with stage T_(3-4),and the difference was statistically significant(P<0.01).The combined examination of ADC value,DWI signal strength and f value was better than the three tests single examination in diagnosing T stage of gastric cancer.Conclusion ADC value combined with DWI can provide a certain clinical basis for the diagnosis of T stage of gastric cancer.However,ADC value is limited in distinguishing T stage of gastric cancer due to various factors.

关 键 词：胃癌 MRI 弥散加权成像 表观弥散系数 T分期 

分 类 号：R735.2[医药卫生—肿瘤]