| Objective:to evaluation the value of clinical application of3.0-T magnetic resonance imaging for preoperative diagnosis and staging of gastric cancer.Materials and Methods:29patients with malignant gastric tumor confirmed by gastroscope admitted to our hospital for magnetic resonance imaging (MRI) enhance examination prior to surgery. The MRI data will be sent to the workstation for observation, measurement and recording relevant data. Much attention was paid to observe the lesion site, size, shape, infiltration depth of gastric wall, whether the surrounding tissues and organs were infringed or not, and lymph nodes and other organs were involved, as well as to analyze the advantages of different MRI sequences and plans in diagnosis and staging of gastric tumor. First, the image quality was graded according to the gastric cavity expansion, breathing artifacts and gastric peristalsis artifacts on imaging, and then we evaluate its’ influence on the diagnosis and staging of gastric tumor. Based on the observation on MRI and measurement data, we make the preoperative staging of gastric cancer according to the TMN classification. The results were compared with the stage of pathology and MSCT. Then make the statistical analysis to evaluate the value of clinical application of3.0-T magnetic resonance imaging in the preoperative diagnosis and staging of gastric cancer.Results:(1) Among the29patients successfully examined with MRI, gastric cancer was diagnosed in27cases and GIST in2cases. All29patients were confirmed by surgical or/and gastroscopic histology with an accuracy of100%with MRI. Subtotal or total gastrectomy was performed in23patients with gastric cancer and2patients with GIST, and surgery was denied by another4patients with gastric cancer because of other organs metastasis and resorted for cancer chemotherapy.(2) Local gastric wall thickening and improved enhanced obviously, lymph nodes enlargement around the stomach and large blood vessels and obviously improved, and infringement of perigastric fat, blood vessels and adjacent organ were the main presentations of Gastric cancer on MRI.(3) In the evaluation of T stage, MRI had a total accuracy of87.0%, sensitivity of95.7%, and specificity of90.9%, respectively. The accuracy for periods were T166.7%(2/3), T266.7%(2/3), T3100%(15/15), and T450%(1/2) respectively. In the evaluation of N stage, MRI had a total accuracy of61.0%(13/23), sensitivity of69.6%(16/23) and specificity of81.3%(13/16), respectively. Compared with MSCT, MRI has advantages to evaluate the T stage.(4)3D subtracted dynamic fast scan in arterial, vein and delay period and combined with multiplane scan in a state of breathless on MRI made great help for lesions positioning, qualitation and stage diagnosis.Conclusion:MRI at3.0T was a safe and feasible approach for stomach examination and with a satisfactory imaging quality. The accuracy of MRI in diagnosis gastric cancer is slightly superior to MSCT. In preoperative T stage of gastric cancer, the accuracy, sensitivity, and specificity of MRI were higher than that of MSCT. But in N stage, MRI was inferior to MSCT. Observation gastric cancer with MRI breathless3D subtracted dynamic fast scan, together with axial, coronal and sagittal images can reduce the chance of overstaged or understaged of gastric cancer before surgery and to improve accuracy. |
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