超声双重造影及MRI对胃癌诊断及术前T分期的对比研究

doi:10.7517/issn.1674-0475.191120

摘要/Abstract

摘要： 选取2017年8月~2019年2月我院收治的胃癌患者130例作为研究对象，依据患者病理诊断结果作为金标准，分析磁共振成像（magnetic resonance imaging，MRI）与超声双重造影对胃癌的诊断价值及术前T分期的价值。结果显示，超声双重造影共检出120例胃癌患者，出现10例漏诊，MRI共检出109例胃癌患者，出现21例漏诊。金标准共检出52例T1期、32例T2期、26例T3期、20例T4期患者，超声双重造影诊断出T1期48例，符合率92.31%；T2期30例，符合率93.75%；T3期24例，符合率92.31%；T4期18例，符合率90.00%，进一步分析显示，超声双重造影对不同胃癌T分期的诊断价值均高于MRI。因此，超声双重造影对胃癌的诊断价值及对术前T分期诊断价值均高于MRI。

关键词: 超声双重造影, 磁共振成像, 胃癌, 敏感度, 特异度

Abstract: 130 patients with gastric cancer admitted to our hospital from August 2017 to February 2019 were selected as the research objects. According to the pathological diagnosis results of patients as the gold standard, the diagnostic value of magnetic resonance imaging (MRI) and ultrasound double contrast examination for gastric cancer and the value of T-staging before operation were analyzed. The results showed that 120 cases of gastric cancer were detected by double contrast ultrasound, 10 cases were missed diagnosis, 109 cases were detected by MRI, 21 cases were missed diagnosis. 52 cases of T1, 32 cases of T2, 26 cases of T3,and 20 cases of T4 were detected in the gold standard. 48 cases of T1 were diagnosed by double contrast-enhanced ultrasound, the coincidence rate was 92.31%, 30 cases of T2, the coincidence rate was 93.75%, 24 cases of T3, the coincidence rate was 92.31%, 18 cases of T4, the coincidence rate was 90.00%. Further analysis showed that the value of double contrast-enhanced ultrasonography in the diagnosis of different T stages of gastric cancer was higher than that of MRI.From the results of this study, we conclude that the value of double contrast-enhanced ultrasonography in the diagnosis of gastric cancer and T-staging before operation is higher than that of MRI.

Key words: ultrasound double contrast, magnetic resonance imaging(MRI), gastric cancer, sensitivity, specificity

韩琳, 刘晔, 马生君, 王静. 超声双重造影及MRI对胃癌诊断及术前T分期的对比研究[J]. 影像科学与光化学, 2020, 38(3): 514-519.

HAN Lin, LIU Ye, MA Shengjun, WANG Jing. Comparative Study of Dual Contrast-enhanced Ultrasound and MRI in the Diagnosis and Preoperative T Staging of Gastric Cancer[J]. Imaging Science and Photochemistry, 2020, 38(3): 514-519.

参考文献

[1] Liu Z L,Chen Z Y,Fan R H,et al. Over-expressed long noncoding RNA HOXA11-AS promotes cell cycle progression and metastasis in gastric cancer[J]. Molecular Cancer, 2017,16(1):82.
[2] Li B, Zhang S, Shen H, et al. MicroRNA-144-3p suppresses gastric cancer progression by inhibiting epithelial-to-mesenchymal transition through targeting PBX3[J]. Biochemical and Biophysical Research Communications, 2017,484(2):241-247.
[3] Kohei S T,Keisho C,Takaki Y K,et al. Phase II study of adjuvant chemotherapy of S-1 plus oxaliplatin for patients with stage Ⅲ gastric cancer after D2 gastrectomy[J].Gastric Cancer, 2017,20(1):175-181.
[4] 韩炜,李欣文.MRI与螺旋CT对原发性胃癌病灶的诊断价值比较[J].中国CT和MRI杂志,2017,15(2):88-90. Han W, Li X W.MRI and Spiral CT on diagnosis of primary gastric cancer lesions of clinical comparative study[J]. Chinese Journal of CT & MRI, 2017,15(2):88-90.
[5] 王亮,杨琰,王小花,等.超声双重造影与超声内镜评估胃癌术前区域淋巴转移的价值比较[J].中华医学超声杂志(电子版),2017,14(6):423-427. Wang L,Yang Y,Wang X H,et al. Comparison of double contrast-enhanced ultrasonography and endoscopic ultrasonography in evaluating regional lymph node metastasis of gastric cancer[J]. Chinese Journal of Medical Ultrasound, 2017,14(6):423-427.
[6] 英国和爱尔兰上胃肠道外科医师学会. 食管癌和胃癌治疗指南[J]. 胃肠病学, 2012,17(3):173-175. British and Irish Society of Upper Gastrointestinal Surgeons. Guidelines for the treatment of esophageal cancer and gastric cancer[J]. Gastroenterology, 2012,17(3):173-175.
[7] Rausei S, Dionigi G, Boni L. Evaluation of the Seventh American Joint Committee on Cancer/International Union Against Cancer classification of gastric adenocarcinoma in comparison with the sixth classification[J]. Cancer, 2011,117(12):2823-2824.
[8] 冯天斌.哺乳动物雷帕霉素靶蛋白和缺氧诱导因子-1α在胃癌组织中的表达及临床意义[J].山西医药杂志,2017,46(5):514-516. Feng T B.Expression and clinical significance of mammalian rapamycin target protein and hypoxia inducible factor-1α in gastric cancer[J].Shanxi Medical Journal, 2017,46(5):514-516.
[9] 梁江,张云生,金雄伟,等.新辅助化疗联合手术治疗进展期胃癌的疗效观察[J].中华普外科手术学杂志(电子版),2018,12(2):137-139. Liang J, Zhang Y S, Jin X W, et al. Observation on the efficacy of neoadjuvant chemotherapy combined with surgery for advanced gastric cancer[J]. Chinese Journal of General Surgery (Electronic Edition), 2018,12(2):137-139.
[10] Gurzu S, Sugimura H, Orlowska J, et al. Proposal of a Dukes-MAC-like staging system for gastric cancer[J]. Journal of Investigative Medicine:the Official Publication of the American Federation for Clinical Research, 2017,65(2):316-322.
[11] 赵燕, 陈方红, 吴丹. 超声双重造影与多层螺旋CT对胃癌T分期的诊断价值[J]. 中国医师杂志, 2017,19(12):1895-1897. Zhao Y, Chen F H, Wu D.Diagnostic value of double contrast-enhanced ultrasound and multi-slice spiral CT in T-staging of gastric cancer[J]. Chinese Journal of Physicians, 2017,19(12):1895-1897.
[12] 鄢曹鑫, 黄品同, 申屠伟慧,等. 超声双重造影与多层螺旋CT对胃癌术前大体分型诊断价值的比较[J]. 中华普通外科杂志, 2018,33(1):20-24. Yan C X,Huang P T,Shen T W H,et al. Comparison of the diagnostic value of double contrast-enhanced ultrasound and multi-slice spiral CT in preoperative general classification of gastric cancer[J]. Chinese Journal of General Surgery, 2018,33(1):20-24.

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