Comparison Study Of CT、MRI、Ultrasound Examination Methods In Patients With Gastric Cancer On TNM Staging

Objective: To assess the value of MSCT(Multilayer spiral CT), MRI(Magneticresonance imaging) and US(Ultrasound) examination methods in patients with gastriccancer on TNM staging.Methods: Choose40cases of gastric cancer patients who were confirmed bygastroscopy from July2012to January2013, including27males and13females, agedfrom25-73years old, the average age was49years old. All patients were expertmultilayer spiral CT, MRI, ultrasound examination in the week before surgery. CTexamination using GE lightspeed16-row multi-slice spiral CT, underwent threedynamic contrast-enhanced scan, and then carried on three-dimensional reconstruction.MRI examination using GE1.5T HD MRI machine, using8-channel body phased-arraycoil combined with ASSET technology and carried on conventional scanning. USexamination using GE Logiq9type color Doppler ultrasonography. Before theexamination the patients need to be fasting. CT and MRI examination need tointramuscular Anisodus alkali15mg before10-20minutes in the preoperativeexamination, and then filling the stomach cavity with gas, water, ultrasound developer,in order to facilitate observation. Put the postoperative pathological findings contrastwith the results of the above three examination. Using GE ADW4.3workstation forimage processing, focusing on tumor size, depth of invasion, and lymph node metastasisof gastric violations. Statistical analysis was performed using SPSS18.0software, thestatistical methods used x2, McNemar and Kappa consistency test.Results: All the patients, surgery and pathology found that stomach-antral gastriccancer in15cases, six cases of body gastric cancer,10cases of total gastric cancer, fivecases of stomach-antral and body gastric cancer,4cases of cardia gastric cancer. Thetumor pathology classified as: poorly differentiated adenocarcinoma in13cases,well-differentiated adenocarcinoma in19cases, mucinous adenocarcinoma in4cases, signet ring cell carcinoma in five cases. Borrmann type: type I6cases, type II10cases,type III,14cases, type IV10cases. Tumor invasion depth are classified as follows:5cases of tumor invasion of the mucosa or submucosa,9cases of tumor infiltration intothe muscular layer or subserosal,20cases of tumors invading the serosa but notinvading adjacent structures,6cases of tumor has invaded the surrounding tissue ororgans. Both early gastric cancer were5cases, advanced gastric cancer were35cases.40patients in the surgery removing lymph nodes were672, which pathologicallyconfirmed lymph node metastasis were179. MSCT, MRI, ultrasound T-stagingaccuracy were80%,97.5%,75%; MSCT, MRI, ultrasound N-staging accuracy were75%,50%,55%; MSCT and ultrasound combined diagnosis on N0, N1, N2, overallN-staging accuracy was85%,66.7%,87.5%,80%.Conclusion: T-staging of the gastric cancer diagnosis of the primary tumor, onlyinfringe the stomach wall itself, the best examination method was MRI. N-staging of thegastric cancer diagnosis, On N0-staging Ultrasound was the best examination method.On N1, N2-staging the multi-slice spiral CT Diagnostic with three dynamic enhancedwas the best examination method. Comprehensive measure of the best N-stagingclassification of installments level and overall N-staging diagnostic, The Ultrasound,MSCT joint diagnosis was the best examination method.