CAJ | 학술논문

目的：评价3.0 T MR扩散加权成像(DW-MRI)在不同分化程度胃腺癌中的诊断价值。材料与方法搜集临床术后病理证实的不同分化程度的33例胃癌患者的临床资料和MRI检查资料，回顾性分析其术前常规MRI及DWI图像，测量不同分化程度胃癌及邻近正常胃壁表观扩散系数(ADC)值。结果胃癌在DWI上均呈高信号；ADC值在胃癌与正常胃壁中差异具有统计学意义(P<0.01，t检验)，胃癌ADC值(1.113±0.183)×10-3 mm2/s低于邻近正常胃壁ADC值(3.026±0.191)×10-3 mm2/s。ADC值在不同分化程度的胃腺癌中差异具有统计学意义(P<0.01，LSD-t法)；低分化腺癌ADC值(0.968±0.0626)×10-3 mm2/s低于中分化腺癌(1.041±0.0570)×10-3 mm2/s及高分化腺癌中的ADC值(1.372±0.0506)×10-3 mm2/s。结论 MR DWI及ADC值有助于区分正常胃壁及不同分化程度的胃癌，评价胃癌的生物学行为，在胃癌恶性程度的判定中具有重要意义。
목적：평개3.0 T MR확산가권성상(DW-MRI)재불동분화정도위선암중적진단개치。재료여방법수집림상술후병리증실적불동분화정도적33례위암환자적림상자료화MRI검사자료，회고성분석기술전상규MRI급DWI도상，측량불동분화정도위암급린근정상위벽표관확산계수(ADC)치。결과위암재DWI상균정고신호；ADC치재위암여정상위벽중차이구유통계학의의(P<0.01，t검험)，위암ADC치(1.113±0.183)×10-3 mm2/s저우린근정상위벽ADC치(3.026±0.191)×10-3 mm2/s。ADC치재불동분화정도적위선암중차이구유통계학의의(P<0.01，LSD-t법)；저분화선암ADC치(0.968±0.0626)×10-3 mm2/s저우중분화선암(1.041±0.0570)×10-3 mm2/s급고분화선암중적ADC치(1.372±0.0506)×10-3 mm2/s。결론 MR DWI급ADC치유조우구분정상위벽급불동분화정도적위암，평개위암적생물학행위，재위암악성정도적판정중구유중요의의。
Objective:To evaluate the diagonstic value of the 3.0 T diffusion-weighted magnetic resonance imaging (DW-MRI) in the different degrees differentiation of gastric adenocarcinoma. Materials and Methods:Collecting 33 cases clinical and MRI information of the different degrees differentiation of gastric cancer which conifrmed by the pathology after surgery, retrospective analysis their conventional MRI and DWI images preoperative, measure apparent diffusion coefifcient (ADC) values of the gastric cancer and the adjacent normal gastric wall. Results:Gastric cancer showed a high signal on DWI, there was a signiifcant statistical differences in the gastric cancer and the normal gastric wall (P<0.01, t-test), the gastric cancer ADC value(1.113±0.183)× 10-3 mm2/s was lower than the normal gastric (3.026±0.191)×10-3 mm2/s. And also there was a significant statistical differences in the three groups (P<0.01, LSD-t). Poorly differentiated gastric adenocarcinoma ADC value [(0.968±0.0626)× 10-3 mm2/s] is lower than the moderately differentiated ADC value [(1.041±0.0570)× 10-3 mm2/s] and the highly differentiated ADC value [(1.372±0.0506)×10-3 mm2/s]. Conclusions:MRI-DWI and ADC values can distinguish the normal gastric and the different degrees differentiation of the gastric adenocarcinoma, and evaluate their biological behavior, there is a important meaning in the determing the degree of malignancy of gastric cancer.