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中华消化病与影像杂志(电子版) ›› 2024, Vol. 14 ›› Issue (06) : 519 -523. doi: 10.3877/cma.j.issn.2095-2015.2024.06.007

论著

MSCT、DCE-MRI 评估术前胃癌TNM 分期的准确性研究
张立俊1, 孙存杰1,(), 胡春峰1, 孟冲1, 张辉2   
  1. 1.221006 江苏省,徐州医科大学附属医院影像科
    2.221006 江苏省,徐州市中医院影像科
  • 收稿日期:2024-07-06 出版日期:2024-12-01
  • 通信作者: 孙存杰

Accuracy of MSCT and DCE-MRI in evaluating preoperative TNM staging of gastric cancer

Lijun Zhang1, Cunjie Sun1,(), Chunfeng Hu1, Chong Meng1, Hui Zhang2   

  1. 1.Department of Imaging,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China
    2.Department of Imaging,Xuzhou Hospital of Traditional Chinese Medicine,Xuzhou 221006,China
  • Received:2024-07-06 Published:2024-12-01
  • Corresponding author: Cunjie Sun
引用本文:

张立俊, 孙存杰, 胡春峰, 孟冲, 张辉. MSCT、DCE-MRI 评估术前胃癌TNM 分期的准确性研究[J]. 中华消化病与影像杂志(电子版), 2024, 14(06): 519-523.

Lijun Zhang, Cunjie Sun, Chunfeng Hu, Chong Meng, Hui Zhang. Accuracy of MSCT and DCE-MRI in evaluating preoperative TNM staging of gastric cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(06): 519-523.

目的

分析胃癌术前多层螺旋CT(MSCT)、动态对比增强MRI(DCE-MRI)诊断TNM 分期与术后病理结果的一致性,以期为临床制定治疗方案提供可靠影像学资料。

方法

回顾性选取徐州医科大学附属医院2022 年1 月至2023 年12 月经胃镜活检病理证实为胃癌,行MSCT和DCE-MRI 检查,并行手术治疗的胃癌患者102 例。由两位具有10 年以上经验的放射科医师采双盲法阅片MSCT 和MRI 影像学图像,以术后病理结果为金标准,计算不同检查评估胃癌TNM 分期的准确率,采用Kappa 检验以分析MSCT、DCE-MRI 检查结果与术后病理结果的一致性。

结果

102例胃癌患者术后病理结果显示:T1~4 期分别为有20、18、21、43 例,N0~3 期分别为28、19、18、37例,M0 期98 例、M1 期4 例。与术后病理检查结果对比,MSCT 检查诊断胃癌T 分期诊断总准确率为72.54%(74/102),显著低于DCE-MRI 检查的91.17%(93/102);MSCT 检查诊断胃癌N 分期总准确率为72.54%(74/102),显著低于DCE-MRI 检查的86.27%(88/102);MSCT 检查诊断胃癌M 分期总准确率为92.15%(94/102),较DCE-MRI 检查的97.05%(99/102)无显著差异。MSCT、DCE-MRI 诊断胃癌M 分期的Kappa 值相近(0.927、0.958);而DCE-MRI 诊断胃癌T、N 期的Kappa值分别为0.927、0.876,优于MSCT 检查。

结论

相对MSCT 检查,DCE-MRI 评估胃癌TNM 分期的准确性更高,与术后病理的一致性更为显著,能为胃癌的术前诊断提供有力的影像学支持。

Objective

To analyze the consistency between preoperative multi-slice spiral CT(MSCT) and dynamic contrast enhanced MRI (DCE-MRI) diagnosis of TNM staging and postoperative pathological results of gastric cancer,in order to provide reliable imaging data for clinical treatment.

Methods

A total of 102 patients with gastric cancer confirmed by gastroscopy biopsy and pathology in our hospital from January 2022 to December 2023 were selected,who underwent MSCT and DCE-MRI examinations and underwent concurrent surgical treatment. MSCT and MRI images were reviewed by two radiologists with more than 10 years of experience in double-blind method. Postoperative pathologic results were used as the gold standard to calculate the accuracy of different examinations in evaluating TNM staging of gastric cancer. Kappa test was used to analyze the consistency of MSCT and DCE-MRI examination results with postoperative pathological findings.

Results

The postoperative pathological results of 102 patients showed that there were 20,18,21 and 43 cases in T1-4 stage,respectively,and 28,19,18 and 37 cases in N0-3 stage,respectively. There were 98 cases of M0 stage and 4 cases of M1 stage.Compared with postoperative pathological findings,the total accuracy of MSCT examination in the diagnosis of gastric cancer T stage was 72.54% (74/102),which was significantly lower than that of DCE-MRI (91.17%,93/102). The total accuracy of MSCT in the diagnosis of N stage of gastric cancer was 72.54% (74/102),which was significantly lower than 86.27% (88/102) of DCE-MRI. The overall accuracy of MSCT in the diagnosis of M stage of gastric cancer was 92.15% (94/102),which was not significantly different from that of DCE-MRI (97.05%,99/102). The Kappa value of MSCT and DCE-MRI in the diagnosis of M stage of gastric cancer was similar (0.927 vs. 0.958). The Kappa values of DCE-MRI in the diagnosis of T and N stage of gastric cancer were 0.927 and 0.876,respectively,which were better than those of MSCT.

Conclusion

Compared with MSCT examination,DCE-MRI has higher accuracy in evaluating TNM staging of gastric cancer and more significant consistent with postoperative pathology,which can provide powerful imaging support for preoperative diagnosis of gastric cancer.

表1 胃癌患者术后病理资料(n=102)
表2 术前MSCT、DCE-MRI 对胃癌T 分期的诊断效果
表3 术前MSCT、DCE-MRI 检查对胃癌N 分期的诊断效果
表4 MSCT、DCE-MRI 诊断胃癌TNM 分期与术后病理结果的一致性分析
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