The Diagnostic Value With 3.0T MRI And 64 MSCT In Advanced Gastric Cancer

Objective Applied the 3.0TMRI and 64 MSCT for N-staging of gastric cancer before surgery,and contrastive analyzed the diagnostic value of the gastric cancer of reoperative –N staging and the nature of lymph nodes in MRI and MSCT,to explore the better method to improve the lymph node excision rate.Metheds 26 patients with gastric carcinoma proved by gastroscopy and biopsy had MRI and MSCT before surgery one week,according to the imaging to evaluated the –N staging and then compare with biopsy after surgery.Through clinical postoperative pathologic lymph nodes and the corresponding target image transfer and the metastasis of lymph node imaging characteristics were summarized.Results There was a good consistency of N-staging in MRI and MSCT compare with biopsy(kappa-test,p<0.05),the accuracy of N-staging before surgery by MRI and MSCT were 69.23%(18/26)and 80.77%(21/26)77.5%(31/40)respectively,and th at of N1-staging were 50.00%(1/2)and 50.0%(1/2),of N2-staging were 83.33%(5/6)and 66.67%(4/6),of N3a-staging were 69.23%(9/13)and 80.00%(12/13),of N3b-staging were 60.00%(3/5)and 80.00%(4/5)respectively.There was no statistical differences in these two methods(McNemar-test,p>0.05).The corresponding target lymph nodes(LNs)were 120,including 53 metastatic and 67 non-metastatic LNs,the short-axis,long-axis and rADC were(1.053±0.156)cm,(2.348±0.611)cm,(0.719±0.075)and(1.020±0.144)cm,(2.138±0.817).cm,(0.977±0.079)on DW and MRI image s respectively.There was no statistical differences of the short-axis and long-axis betw een metastatic and non-metastatic LNs.There was statistical differences of the rADC between metastatic and non-metastatic LNs,the rADC value of metastatic LNs were si gnificantly lower than that of non-metastatic LNs(p=0.000).The short-axis,long-axisand enhanced degree of metastatic LNs and non-metastatic LNs were(1.066±0.171)c m,(2.191±0.676)cm,(48.8±5.8)HU and(1.020±0.144)cm,(2.138±0.818)cm and(24.2±8.3)HU on MSCT images respectively.There was no statistical difference of t he short-axis and long-axis between metastatic and non-metastatic LNs on MSCT imag es.There was statistical differences of the enhanced degree between metastatic and no n-metastatic LNs,the enhanced degree of metastatic LNs were significantly greater tha n that of non-metastatic LNs(p=0.000).Conclusion 1.There was a good consistency of reoperative N staging in MRI and MSCT compared with biopsy N staging after surgery.2.MSCT imaging was comparable to MRI in the N-staging of the gastric cancer,the accuracy of MSCT was superior to MRI,especially in N3 a and N3 b staging.3.MRI and MSCT had great value of determine the nature of metastatic LNs and non-metastatic LNs,there were different characteristics between metastatic LNs and non-metastatic LNs.