【摘要】 目的：探究动态增强磁共振成像（DCE-MRI）及弥散加权成像（DWI）序列在胃癌术前分期的诊断价值。方法：选取医院收治的76例胃癌患者，均于手术前应用磁共振成像（MRI）行DCE-MRI及DWI序列扫描，其后接受手术并行病理检查，以病理分期结果作为金标准，采用Kappa检验对两种扫描序列进行一致性分析，对比分析胃癌患者MRI影像学表现及DWI与DCE-MRI序列对胃癌术前肿瘤-淋巴结-远处转移（TNM）分期的诊断价值。结果：DCE-MRI结果显示，76例胃癌患者中胃壁均增厚，平均厚度为（16.33±1.69）mm;T₁加权成像（T₁WI）低信号和等信号分别为46例和30例；DWI结果显示为弥散性高信号，表观弥散系数（ADC）信号显著下降，时间-强度曲线（TIC）的流入型、平台型和流出型分别为23例、35例和18例，强化情况不规则59例，分层强化17例。DWI诊断胃癌术前T1期、T2期、T3期和T4期Kappa值分别为0.874、0.721、0.654和0.699;DCE-MRI的Kappa值分别为0.934、0.856、0.815和0.809。DWI诊断胃癌术前N0期、N1期和N2期Kappa值分别为0.889、0.813和0.849;DCE-MRI的Kappa值分别为0.709、0.651和0.852。DWI诊断胃癌术前M分期Kappa值为0.617,DCE-MRI的Kappa值为0.934。结论：DWI及DCE-MRI序列在胃癌术前分期诊断中各有优势，具有一定临床价值，可为患者术后治疗提供有效依据。更多还原

【Abstract】 Objective: To explore the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） and diffusion-weighted imaging（DWI） sequences in preoperative staging of gastric cancer. Methods:A total of 76 patients with gastric cancer admitted to the hospital were selected, all of them underwent DCE-MRI and DWI sequence scanning by magnetic resonance imaging（MRI） before surgery, and then underwent surgery and pathological examination. Using pathological staging results as the gold standard, Kappa test was used to analyze the consistency of the two scan sequences. MRI imaging manifestations of gastric cancer patients and the diagnostic value of DWI and DCE-MRI sequences in preoperative tumor-lymph node-distant metastasis（TNM） staging of gastric cancer were compared and analyzed. Results: The results of DCE-MRI showed that the gastric wall was thickened in all the 76 patients with gastric cancer, the average thickness was（16.33±1.69） mm. T₁-weighted imaging（T₁WI）hypointense and isointense were 46 cases and 30 cases, respectively. DWI showed diffuse hyperintensity, apparent diffusion coefficient（ADC） signal decreased significantly, the time-intensity curve（TIC） inflow type, plateau type and outflow type were 23 cases, 35 cases and 18 cases, respectively; the enhancement was irregular in 59 cases and the enhancement was stratified in 17 cases. Kappa values of DWI in the preoperative T1, T2, T3 and T4 stages of gastric cancer were 0.874, 0.721, 0.654 and 0.699, respectively; Kappa values of DCE-MRI were 0.934, 0.856, 0.815 and 0.809,respectively. Kappa values of DWI in the diagnosis of preoperative N0, N1 and N2 stages of gastric cancer were 0.889,0.813 and 0.849, respectively; Kappa values of DCE-MRI were 0.709, 0.651 and 0.852, respectively. Kappa value of DWI in the diagnosis of preoperative M staging of gastric cancer was 0.617, and Kappa value of DCE-MRI was 0.934.Conclusion: DWI and DCE-MRI sequences have their own advantages in the preoperative staging diagnosis of gastric cancer, and have certain clinical value, which can provide effective bases for postoperative treatment.更多还原