磁共振弥散加权成像与MSCT对胃癌患者术前分型及T分期诊断价值的比较

Magnetic resonance imaging-diffusion weighted imaging vs multi-slice computed tomography for preoprative typing and T-staging of gastric cancer

目的:探讨磁共振(magnetic resonance imaging,MRI)弥散加权成像(diffusion weighted imaging,DWI)与多层螺旋计算机断层扫描(multislice computed tomography,MSCT)对胃癌术前分型以及T分期的诊断价值.方法:选取2012-11/2013-08来青海大学附属医院就诊经胃镜活检病理确认的102例胃癌患者,术前分别行MSCT和MRI-DWI检查.由两位放射科医师分别对癌灶进行检测和T分期,并以手术病理结果为金标准,比较MSCT与MRI-DWI的胃癌分型及T分期诊断准确率,比较观察者间一致性.结果:MRI-DWI胃癌术前分型诊断准确率高达96.1%,显著高于MSCT诊断(83.3%)(P<0.01).MRI-DWI对胃癌患者总体T分期的诊断准确率为90.20%(92/102),明显高于MSCT 70.59%(72/102)(P<0.01).MR诊断的观察者间一致性(Kappa=0.813)优于MSCT诊断(Kappa=0.603).结论:MRI-DWI对胃癌术前分型及T分期的诊断准确性显著高于MSCT,值得进一步临床推广应用.

AIM：To compare the performance of magnetic resonance imaging-diffusion weighted imaging（MRI-DWI） and multislice computed tomography（MSCT） in preoperative typing and T-staging of gastric cancer.METHODS：One hundred and two patients with pathologically confirmed gastric cancer who underwent either MSCT or MRI-DWI preoperatively at our hospital from November2012 to August 2013 were included.Using pathologic results as the golden standard,the accuracy of MSCT and MRI-DWI for preoperative typing and T-staging of cancer were compared.RESULTS：The accuracy of MRI-DWI in typing gastric cancer before surgery was 96.1%,which was significantly higher than that of MSCT（83.3%）（P 〈 0.01）.The accuracy of MRI-DWI in T-staging of gastric cancer before surgery was 90.20%（92/102）,which was significantly higher than that of MSCT（70.59%,72/102）（P〈 0.01）.Interobserver consistency for MRI-DWI（Kappa = 0.813） was superior to that for MSCT（Kappa = 0.603）.CONCLUSION：The accuracy of MRI-DWI in preoperative typing and T-staging of gastric cancer is much higher than that of MSCT.