[1]王志军,丛英珍,许祖闪,等.高场强MRI在胃癌术后复发诊断中的应用价值[J].国际放射医学核医学杂志,2010,34(6):370-373.[doi:10.3760/cma.j.issn.1673-4114,2010.06.014]
　WANG Zhi-jun,CONG Ying-zhen,XU Zu-shan,et al.Application of high-field-strength magnetic resonance imaging to diagnose recurrent gastric carcinoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(6):370-373.[doi:10.3760/cma.j.issn.1673-4114,2010.06.014]
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高场强MRI在胃癌术后复发诊断中的应用价值(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
34
期数:
2010年第6期
页码:
370-373
栏目:
临床放射医学
出版日期:
1900-01-01

文章信息/Info

Title:
Application of high-field-strength magnetic resonance imaging to diagnose recurrent gastric carcinoma
作者:
王志军;  丛英珍;  许祖闪;  全勇
山东省威海市文登中心医院影像科, 264400
Author(s):
WANG Zhi-jun;  CONG Ying-zhen;  XU Zu-shan;  QUAN Yong
Department of Radiology, Wendeng Central Hospital, Shandong Wendeng 264400, China
关键词:
胃肿瘤; 肿瘤复发; 局部; 磁共振成像
Keywords:
Stomach neoplasms; Neoplasms recurrence; local; Magnetic resonance imaging
DOI:
10.3760/cma.j.issn.1673-4114,2010.06.014
摘要:
目的 探讨高场强MRI在胃癌术后复发诊断中的应用价值及临床意义。方法 选择胃癌术后患者43例。其中,胃癌术后复发组33例,均经过消化道钡餐、CT、手术或胃镜活检和病理检查确诊;对照组10例,均经胃镜活检及病理检查证实无复发。MRI检查前使用低张剂,服用水做为阴性对比剂,应用1.5TMR快速扰相梯度回波序列、快速恢复自旋回波序列、扩散加权成像、真稳态进动快速序列等及动态增强扫描检查方法。结果 MRI诊出胃癌术后复发患者30例。对照组残胃壁厚度(4.5±0.3) mm,吻合口胃壁厚度(6.3±1.4) mm;复发组残胃吻合口胃壁增厚>8mm者30例,吻合口邻近胃壁厚度>5 mm者19例,吻合口软组织肿块并邻近胃壁增厚者11例,肝脾胰腺等周围脏器转移者5例,肝胃之间、腹腔、腹膜后淋巴结转移者9例,病灶在动脉期不均匀强化者9例,静脉期及平衡期病灶呈渐进性、延迟强化者30例。结论 MRI较好地显示了残胃壁及吻合口胃壁的厚度,能够准确判断肿瘤浸润深度、是否与周围组织有毗邻关系以及是否有淋巴结和腹腔内脏器转移等,可以用来指导临床手术方案的选择或综合治疗,对提高胃癌术后生存率具有重要的临床意义。
Abstract:
Objective To evaluate the clinical application of high-field-strength magnetic resonance imaging to diagnose recurrent gastric cancer.Methods Forty three postoperative patients with gastric carcinoma were divided into two groups. The group with recurrent gastric carcinoma has 33 patients, they were clinically confirmed by barium meal of alimentary canal, CT or pathological results. There were 10 cases in control group confirmed by pathological results. All the subjects took hypotonicity agent, followed by water as negative contrast medium. Then patients underwent magnetic resonance imaging including fast spoiled gradient recalled T1WI, T2WI, diffusion weighted imaging, fast imaging employing steady state sequence, magnetic resonance cholangiopancreatographyand dynamic contrast enhancement sequences when gastrointestinal tract was in hypotonic, patients drank or were primed with water as contrast.Results Thirty patients were diagnosed as recurrent gastric cancer with MRI, 28 of them were confirmed by clinical results. Three patients were missed and two patients were incorrectly misdiagnosed by MRI. Wall thickness of gastric remnant was (4.5±0.3) mm and that of stomas was (6.3±1.4) mm in control group. Types of lesions were found on MRI:thickening of remnant stomach stomas was more than 8 mn(n=30), thickening of neighbor rem-nant stomach stomas was more than 5mm (n=19), mass of stomas (n=11), metastasis of neighbor viscus (n=5), and metastasis of lymph nodes (n=9). On enhancement scan, 9 patients showed inhomogeneous enhancement in arterial phase and 30 patients showed gradual delayed enhancement in venous phase and equilibrium phase.Conclusion MRI is an effective imaging method in illustrating wall thickness of gastric remnant and stomas, invasion depth by carcinoma, relationship with neighbor tissue structures and metastasis of lymph nodes and abdominal viscus. It plays an important role in directing clinical therapy.

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备注/Memo

备注/Memo:
收稿日期:2010-01-22。
通讯作者:王志军(E-mail:shanmiaozi@tom.com)
更新日期/Last Update: 1900-01-01