CAJ | 학술논문

目的比较增强CT与含弥散加权成像(DWI)的磁共振(MR)成像对胃癌术前T分期诊断的准确率.方法前瞻性纳入2011年11月至2012年8月间经胃镜活检病理证实的41例胃癌患者,术前分别予增强CT和MR检查(包含DWI、T2WI和动态增强扫描).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CT与MR的T分期准确率以及观察者间一致性.结果含DWI的MR对胃癌患者总体T分期的诊断准确率为87.8％(36/41),明显高于增强CT 65.9％(27/41)的诊断准确率(P=0.004).MR诊断的观察者间一致性(Kappa=0.813)优于增强CT诊断(Kappa=0.603).结论含DWI的MR成像对胃癌术前T分期的诊断准确率较增强CT显著提高,有望于临床广泛应用.
목적 비교증강CT여함미산가권성상(DWI)적자공진(MR)성상대위암술전T분기진단적준학솔.방법 전첨성납입2011년11월지2012년8월간경위경활검병리증실적41례위암환자,술전분별여증강CT화MR검사(포함DWI、T2WI화동태증강소묘).유량위방사과의사분별대암조진행검측화T분기,병이수술병리결과위금표준,비교CT여MR적T분기준학솔이급관찰자간일치성.결과 함DWI적MR대위암환자총체T분기적진단준학솔위87.8％(36/41),명현고우증강CT 65.9％(27/41)적진단준학솔(P=0.004).MR진단적관찰자간일치성(Kappa=0.813)우우증강CT진단(Kappa=0.603).결론 함DWI적MR성상대위암술전T분기적진단준학솔교증강CT현저제고,유망우림상엄범응용.
Objective To compare the accuracy of CT and MR including diffusion-weighted imaging (DWI) in preoperative diagnosis and T staging of gastric cancer.Methods Forty-one patients with gastric cancers proved by gastroscopy biopsy from November 2011 to August 2012 were prospectively enrolled.They underwent contrast enhanced CT and MR imaging (including DWI,T2 weighted and dynamic enhanced imaging) preoperatively.Two radiologists interpreted CT and MR images for detecting and staging each patient independently.With the reference of post-operative histopathological findings,T staging accuracy of CT and MR imaging was calculated and compared.Inter-observer agreement was also evaluated.Results Overall T staging accuracy in MR including DWI was significantly higher than that in CT imaging (87.8％ vs.65.9％,P=0.004).MR had a better interobserver agreement than CT(Kappa=0.813,0.603,respectively).Conclusion MR including DWI can improve preoperative T staging accuracy of gastric cancer significantly,which deserves recommendation for clinical application.