Diagnostic Evaluation Of Advanced Ulcerative Gastric Cancer With MRI: A Comparative Study With Pathology

Objective Analyse the 3.0T MRI images,gross classification and T-staging of advanced ulcerative gastric cancer,and compare with postoperative histopathology diagnosis,to investigate the preoperative diagnostic value of MRI in advanced ulcerative gastric cancer,and provide the reliable basis for clinical diagnosis and treatment.Methods Patients with advanced ulcerative gastric cancers who were diagnosed by gastroscopy and biopsy performed 3.0T MRI scan before surgery,and collect the clinical datum of 29 patients with advanced ulcerative gastric cancers in different degree of differentiation were diagnosed by postoperative pathological results.Analyse the MRI image datum,Borrmann classification,T-staging and measure the ADC value,then compare with postoperative pathological results,to investigate the preoperative diagnostic value of MRI in advanced ulcerative gastric cancer with different gross classification and degree of differentiation.Results It can clear to display the location,shape,strengthening characteristics,invasion depth,range and relationship with surrounding structure of advanced ulcerative gastric cancer by 3.0T MRI.The accuracy of the evaluation of Borrmann II and Borrmann III using MRI in advanced gastric cancer was respectively 82.76% and 82.76%,Kappa value is respectively 0.640 and 0.640,p<0.05,and both have better consistency.The accuracy of the evaluation of T2,T3,T4 using MRI in advanced ulcerative gastric cancer was respectively 89.66%,79.31% and 89.66%,Kappa value is respectively 0.731,0.586 and 0.791,p<0.05,and all have better consistency.The average ADC value of advanced ulcerative gastric cancer is(1.17±0.22)×10-3mm2/s,and the average ADC value of normal gastric wall is(3.08±0.39)×10-3 mm2/s.There is statistically significant difference of independent samples t test in this two groups(p<0.05).The average ADC value of highly differentiated gastric cancer is(1.46±0.17)×10-3mm2/s,the average ADC value of middle differentiated gastric cancer is(1.23±0.10)×10-3mm2/s,and average ADC value of low differentiated gastric cancer is(1.06±0.16)×10-3mm2/s.There are statistically significant differences of one-way ANOVA analysis in this three groups(p<0.05).Comparing the strengthening characteristics of LAVA dynamic enhancement between highly/middle differentiated gastric cancer and low differentiated gastric cancer,there is statistically significant differences of Fisher exact probability test(p<0.05).Conclusion There is in better consistency between the evaluatio n of Borrmann classification of preoperative MRI multi-sequence imaging and postoperative results in advanced ulcerative gastric cancer,and there is in better consistency between the evaluation of preoperative T-staging and postoperative T-staging.The strengthening characteristics of LAVA dynamic enhancement are closely related to the degree of differentiation of advanced ulcerative gastric cancer,which can value the degree of differentiation in advanced ulcerative gastric cancer before surgery.DWI imaging contributes to identify of gastric cancer and the normal gastric wal,and ADC value is of great significance in the assessment of grade of advanced ulcerative gastric cancer.