磁共振成像和多层螺旋CT对胃癌术前分期的比较研究

A comparative study of magnetic resonance imaging and multi-slice spiral CT in preoperative staging of gastric carcinoma

目的探讨磁共振成像(magneticresonanceimaging,MRI)和多层螺旋CT(multi-slicespiralCT,MSCT)对胃癌术前分期的价值。方法对27例经胃镜活检证实的胃癌患者术前行磁共振成像和多层螺旋CT检查,并与术后病理检查结果对照。结果MRI和MSCT对胃癌T分期的判断准确率分别为81.5%(T1100%,T257.1%,T381.8%,T4100%)和77.8%(T1100%,T257.1%,T372.7%,T4100%),差别无统计学意义(P>0.05)。MRI和MSCT对胃癌N分期的判断准确率分别为63.6%(N077.8%,N160.0%,N250.0%)和72.7%(N066.7%,N180.0%,N275.0%),尽管二者无显著差异(P>0.05),但MSCT对胃癌N分期的判断准确率和对淋巴结转移的敏感性稍高于MRI。MRI对胃癌M分期的判断准确率与MSCT基本一致,同时,MRI和MSCT对胃癌TNM分期的总体判断准确率无显著差异(P>0.05)。结论MRI由于其对胃癌术前N分期的局限性目前尚不能完全取代MSCT在胃癌术前分期中的应用。

[Objective] To investigate the value of magnetic resonance imaging （MR/） and multi-slice spiral CT （MSCT） in preoperative staging of gastric carcinoma. [Methods] MR/and MSCT were performed in 27 patients with gastric carcinoma proved by means of biopsy, and the results were compared with postoperative pathologic findings. [Results] The accuracy of MRI and MSCT in T staging was 81.5% （TI 100%, T2 57.1%, T3 81.8%, T4 100%, respectively） and 77.8% （TI 100%, T2 57.1%, T3 72.7%, T4 100%, respectively）, respectively, and there was no statistical difference （P 〉0.05）. The accuracy of MR/and MSCT in N staging was 63.6% （No 77.8%, N1 60.0%, N2 50.0%, respectively） and 72.7% （No 66.7%, N1 80.0%, N2 75.0%, respectively）, respectively. Although there was no statistical difference （P〉0.05）, the accuracy for N staging and the sensitivity for lymph node metastasis with MSCT were slightly higher than those with MRI. The accuracy of MRI in M staging was equal to that of MSCT. In addition, there was no statistical difference between MRI and MSCT in the overall accuracy of TNM staging （P 〉0.05）. [Conclusion] MR/cannot replace MSCT in preoperative staging of gastric carcinoma because of its limitation in N staging.