Yamada I, Saito N, Takeshita K, Yoshino N, Tetsumura A, Kumagai J, Shibuya H
Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Radiology. 2001 Jul;220(1):115-21. doi: 10.1148/radiology.220.1.r01jl10115.
To determine signal intensity characteristics of the gastric wall layers and to assess the accuracy of the evaluation of early gastric carcinomas in vitro by using resected specimens studied with high-spatial-resolution magnetic resonance (MR) imaging.
Fifteen gastric specimens obtained from patients suspected of having early gastric carcinoma were studied with a 1.5-T MR system with a 4-cm-diameter loop coil. High-spatial-resolution spin-echo MR images were obtained with a field of view of 50 mm, a matrix of 256 x 256, and a section thickness of 2 mm, resulting in a voxel size of 0.08 mm(3). Findings from MR images were compared with histopathologic findings.
T1- and T2-weighted MR images clearly depicted the normal gastric wall as consisting of four and six layers, respectively, which corresponded well to the histologic layers. In 14 (93%) of 15 gastric carcinomas, the depth of mural invasion visualized with MR imaging correlated well with the histopathologic stage. The stage determined with MR imaging, however, was lower in one instance (7%) than the histopathologic stage. MR imaging also depicted the gross features of the tumor, presence of ulceration, and adjacent lymph node swelling.
High-spatial-resolution MR imaging has a high diagnostic accuracy in the evaluation of the mural invasion of early gastric carcinoma in vitro and thus potentially enables preoperative histopathologic staging.
通过对切除标本进行高空间分辨率磁共振(MR)成像研究,确定胃壁各层的信号强度特征,并评估体外早期胃癌评估的准确性。
对15例疑似早期胃癌患者的胃标本,使用配备4厘米直径环形线圈的1.5-T MR系统进行研究。采用视野为50毫米、矩阵为256×256、层厚为2毫米的高空间分辨率自旋回波MR成像,体素大小为0.08立方毫米。将MR图像的结果与组织病理学结果进行比较。
T1加权和T2加权MR图像清楚地显示正常胃壁分别由四层和六层组成,与组织学层次非常吻合。在15例胃癌中的14例(93%)中,MR成像显示的壁内浸润深度与组织病理学分期密切相关。然而,有1例(7%)MR成像确定的分期低于组织病理学分期。MR成像还显示了肿瘤的大体特征、溃疡的存在以及相邻淋巴结肿大。
高空间分辨率MR成像在体外评估早期胃癌壁内浸润方面具有较高的诊断准确性,因此有可能实现术前组织病理学分期。