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早期胃癌:体外高空间分辨率磁共振成像评估

Early gastric carcinoma: evaluation with high-spatial-resolution MR imaging in vitro.

作者信息

Yamada I, Saito N, Takeshita K, Yoshino N, Tetsumura A, Kumagai J, Shibuya H

机构信息

Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

出版信息

Radiology. 2001 Jul;220(1):115-21. doi: 10.1148/radiology.220.1.r01jl10115.

Abstract

PURPOSE

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

材料与方法

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。

结果

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。

结论

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。

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