Application Of MRI In The Preoperative Staging Of Gastric Cancer

Objective:To investigate the value of MRI in preoperative staging of gastric cancer.Methods:28 patients confirmed gastric cancer by gastroscopy and biopsy,which come from First Affiliated Hospital of Kunming Medical University between June 2015 and December 2016,were administrated MRI examination before surgery.Compare the preoperative staging were evaluated by MRI with the postoperative staging were evaluated by pathological.Results:1.Among the 28 patients,1 case was classified into stage T1,7 cases were classified into stage T2,11 cases were in stage T3 and 9 cases were in stage T4 by MRI examination.Meanwhile,there were 3 cases in stage T1,3 cases in stage T2,12 cases in stage T3 and 10 cases in stage T4 by pathological diagnosis.Contrastive analysis between the MRI and pathological diagnosis on the T stage:T1 stage with 33.3%sensitivity,100%specificity and 92.9%accuracy.T2 stage with 66.7%sensitivity,80%specificity and 78.6%accuracy.T3 stage with 66.7%sensitivity,81.2%specificity and 75%accuracy.T4 stage with 80%sensitivity,94.4%specificity and 89.3%accuracy.The results in N stage:10 cases were classified into N0,5 cases were in N1,8 cases were in N2 and 5 cases were in N3 by MRI examination..Meanwhile,there were 9 cases in N0,4 cases in N1,5 cases in N2 and 10 cases in N3 by pathological diagnosis.The results shows:NO stage with 77.8%sensitivity,84.2%specificity and 82.1%accuracy.N1 stage with 25%sensitivity,83.3%specificity and 75%accuracy.N2 stage with 60%sensitivity,78.3%specificity and 75%accuracy.N3 stage with 50%sensitivity,100%specificity and 82.1%accuracy.2.Among the 28 patients,1 case was classified into gastric fundus,9 cases in gastric body,18 cases in the body of gastric gastric antrum.Contrastive analysis between the MRI and pathological diagnosis on gastric body:T1(100%)、T2(77.8%)、T3(77.8%)、T4(100%,P<0.01;NO(77.8%)、N1(88.9%)、N2(66.7%)、N3(88、9%,P<0.01),gastric antrum:T1(88.9%,P<0.01)、T2(77.8%)、T3(77.8%,P<0.01)、T4(88.9%,P<0.01),N0(83.3%,P<0.01)、N1(66.7%)、N2(72.2%)、N3(77.8%).3、Among the 28 patients,20 cases were classified into gastric lesser curvature,7 cases in greater curvature.The accuracy of T、N stage:gastric lesser curvature:T1(90%,P<0.01)、T2(85%,P<0.01)、T3(85%,P<0.01)、T4(90%,P<0.01),NO(90%,P<0.01)、N1(75%)、N2(75%)、N3(80%,P<0.01),Greater curvature T1(100%)、T2(57.1%)、T3(57.1%)、T4(100%,P<0.01),NO(57.1%)、N1(71.4%)、N2(71.4%)、N3(85.7%,P<0.01).4.Among the 28 patients,0 case was classified into Borrmann I,11 cases were classified into Borrmann Ⅱ,8 cases were classified into Borrmann Ⅲ,9 cases were classified into Borrmann Ⅳ.The accuracy of T、N stage:Borrmann Ⅱ:T1(90.9%)、T2(81.8%,P<0.01)、T3(81.8%,P<0.01)、T4(90.9%,P<0.01),NO(81.8%)、N1(63.6%)、N2(54.5%)、N3(72.7%),Borrmann Ⅲ:T1(87.5%,P<0.01)、T2(75%)、T3(75%,P<0.01)、T4(87.5%,P<0.01),N0(87.5%,P<0.01)、N1(75%)‘N2(100%)’N3(87.5%,P<0.01),Borrmann Ⅳ:T1(100%)、T2(77.8%)、T3(66.7%)、T4(88.9%,P<0.01),N0(77.8%,P<0.01)、N1(88.9%,P<0.01)、N2(77.8%)、N3(88.9%,P<0.01).5.Among the 28 patients,2 cases were classified into intestinal type in Lauren classfication,9 cases were classified into mixed type,9 cases were classified into diffuse type(8 cases were unknown).The accuracy of T、N stage:Mixed type:T1(88.9%)、T2(77.8%)、T3(77.8%,P<0.01).T4(88.9%,P<0.01),N0(77.8%,P<0.01)、N1(44.4%)、N2(66.7%)、N3(77.8%),Diffuse type:T1(100%)、T2(88.9%)、T3(77.8%,P<0.01)、T4(88.9%,P<0.01),N0(88.9%,P<0.01)、N1(100%,P<0.01)、N2(77.8%)、N3(88.9%,P<0.01).Conclusion:1、MRI has a higher accuracyof preoperative staging of gastric cancer,especially in the diagnosis of T3、T4、N3 stage.2.The tumor located in the lesser curvature of stomach show a higher accuracy in T、N stage.There is high consistency with pathological diagnosis.3、In different Borrmann types shows a higher accuracy in T4、N3stage and has high consistency with pathological diagnosis.In different types,the accuracy of N3 increased with the classification.4.The diffuse type of Lauren classfication shows a higher accuracy in T、N stage,especially in the diagnosis of N stage.