MRI超清r-FOV DWI诊断胃部病变的临床价值

Clinical value of MRI ultra-clear r-FOV DWI in diagnosis of gastric lesions

目的探讨MRI超清小视野扩散加权成像(r-FOV DWI)诊断及鉴别诊断胃部病变的临床价值。方法搜集34例经胃镜及病理检查证实的胃部疾病患者,利用1.5T MRI扫描仪行常规MRI平扫、r-FOV DWI与常规视野(c-FOV DWI)扫描(b=1000 s/mm2),对病变区与正常胃壁的表观扩散系数(ADC)值分别采用r-FOV DWI与c-FOV DWI图像测量。同时由2位影像诊断医师采用盲法利用4分法,分别对r-FOV DWI及c-FOV DWI图像质量进行主观评分和比较。结果观察者主观评分r-FOV DWI为(3.47±0.50)分,明显高于c-FOV DWI的主观性评分(2.63±0.79)分(P<0.05)。2位影像诊断医师对r-FOV DWI与c-FOV DWI图像主观评分的一致性良好(Kappa值=0.706);r-FOV DWI与c-FOV DWI在正常胃壁、胃腺癌、胃炎、胃淋巴瘤及胃异位胰腺上的ADC值差异无统计学意义(P>0.05)。结论 MRI的r-FOV DWI对诊断及鉴别胃部病变有较好的效果,将两者结合使用有效提高诊断正确率,有利于临床诊断及治疗。

Objective To explore the clinical value of MRI ultra-clear reduced field-of-view diffusion weighted imaging （r-FOV DWI） in the diagnosis and differential diagnosis of gastric lesions. Methods A total of 34 patients with gastric lesions as confirmed by gastroscopy and pathological examination were collected and all received conventional routine MRI scanning, r-FOV DWI, and conventional field-of-view diffusion weighted imaging（c-FOV DWI） （b=1000 s/mm^2） by use of 1.5T MRI scanner, and r-FOV DWI and c-FOV DWI were adopted for measuring the values of apparent diffusion coefficient （ADC） of the lesion and normal gastric wall surface. Finally, subjective evaluation on and comparison between r-FOV DWI and c-FOV DWI images were carried out by two doctors from the Department of Medical Imaging by use of blind method and method of coning and quartering. Results The subjective scores of r-FOV DWI in the observation were 3.47±0.50, significantly higher than that of c-FOV DWI 2.63±0.79（P〈 0.05）; according to the evaluation of the two doctors, the subjective scores of r-FOV DWI and c-FOV DWI images were good （Kappa=0.706）, and there were no significant difference in values of ADC of normal gastric mucosa, gastric gland cancer, gastritis, gastric lymphoma and gastric ectopic pancreas in the r-FOV DWI and c-FOV DWI images between the two groups（P〉 0.05）. Conclusion MRI r-FOV DWI has good effects on the diagnosis and differential diagnosis of gastric lesions. The combination of the two methods can effectively improve the diagnostic accuracy, which is helpful to clinical diagnosis and treatment.