3.0T MRI在胃癌术前评估的价值

Value of 3.0T MRI in preoperative evaluation of gastric cancer

目的评价3.0T MRI在胃癌术前评估的价值和意义。方法回顾性分析2016年9月～2017年12月经手术病理证实的25例胃癌患者的临床资料。所有患者均行常规MRI扫描(包括横断T1WI、T2WI、T2WI-Fs及冠状SSFSE T2WI),DWI及LAVA-Flex动态增强扫描。比较正常和病变区域之间的差异,观察淋巴结及周围包括肝脏转移情况。结果胃癌病变区胃壁增厚、形态改变,T2WI、T2WI-FS信号增高,增强扫描不均匀强化,正常人胃壁平均ADC值为(2.4075±0.1450)×10^(-3) mm^2/s,胃癌平均ADC值为(1.8260±0.1150)×10^(-3) mm^2/s(P<0.01)。DWI显示胃癌病变的信号强度明显高于常规MRI序列,对淋巴结转移显示较敏感,但解剖学细节不如常规MRI表现,T2WI-Fs序列能观察胃癌外周浸润情况。结论 3.0T MRI在胃癌术前评估具有重要的价值。

Objective To evaluate the value and significance of 3.0T MRI in preoperative evaluation of gastric cancer.Methods The clinical data of 25 patients with gastric cancer confirmed by surgical pathology from September 2016 to December 2017 were retrospectively analyzed.All patients underwent routine MRI scans(including T1WI,T2WI,T2WI-Fs,and coronary SSFSE T2WI),DWI and LAVA-Flex dynamic enhanced scans.The differences between normal and diseased areas were compared and the lymph node and surrounding including liver metastasis was observed.Results In gastric cancer lesions,gastric wall thickened and morphological changed;T2WI and T2WI-FS signals increased;and enhanced scanning displayed uneven enhancement.The average ADC value of normal stomach wall was(2.4075±0.1450)×10^-3 mm^2/s,and the average ADC value of gastric cancer was(1.8260±0.1150)×10^-3 mm^2/s(P<0.01).DWI showed that the signal intensity of gastric cancer lesions was significantly higher than that of conventional MRI sequences,and it was more sensitive to lymph node metastasis,but its anatomical details were not as good as conventional MRI.The T2WI-Fs sequence could observe the peripheral infiltration of gastric cancer.Conclusion 3.0T MRI has important value in preoperative evaluation of gastric cancer.