| Background Gastric carcinoma is one of the most common carcinomas worldwide with a high morbidity and mortality,surgical resection remains the only curative treatment for gastric carcinoma.The diagnosis of gastric carcinoma depends on endoscopic biopsy which is an invasive examination and there is still some risks,furthermore,some patients can not tolerate the examination. Quantitative analysis towards perfusion and diffusion which was achieved by multi-b values DWI can accurate make a diagnosis of the lesions, DWI with multi-b values is a non-invasive examination which causes no suffering felling to the patients, and this remains a central issue of the MRI new technique.Objective To investigate the application value of double biexponential model diffusion weighted imaging (IVIM-DWI) in differentiate the gastric adenocarcinoma invasion layers and no carcinoma infiltration layers with the quantitative parameters.Methods 32 patients with gastric adenocarcinoma were included as the case group,and 12 healthy volunteers were recruited as the control group.all the patients were conducted with a abdominal MRI examination with the sequence of axial and sagittal FSPGR T1WI, FSPROP T2WI, Multi-b values DWI. the MRI imaging was performed by using a 3.0-T MRI scanner (GE Discovery 750).Slow ADC,Fast ADC and f values were measured of the carcinoma areas,no carcinoma invasion areas each patient of the case group and the normal gastric layers of the control group respectively. SNK-q test was conducted between the normal gastric layers and the case group’s carcinoma and no carcinoma invasion areas according to the research objective.The ROC curve was depicted depended on the statistic mean value between the groups.Results The mean value of fast ADC of carcinoma layers and no carcinoma invasion areas of the case group was 19.259×10-3±0.01120mm2/s,60.926×10-3±0.05414mm2/s respectively.the fast ADC value of the normal gastric layers was 59.397×10-3±0.0578 mm2/s in the control group,fast ADC value of the carcinoma areas of the case group was lower than the no carcinoma invasion areas and normal gastric layers, F value was 30.393 and 22.572 between them,both of the p value are 0.000 with the statistical significance.The fast ADC value between carcinoma and no carcinoma infiltration areas of the case group was investigated to depict ROC curve,the area under the curve was 0.803,when the threshold was 18.75×10-3mm2/s,the sensitivity and specificity was 0.833 and 0.611,the maximum Youden index YI was 0.444;the fast ADC value between carcinoma and normal gastric layers areas of the control group was investigated to depict ROC curve,the area under the curve was 0.832,when the threshold was 19.25×10-3mm2/s,the sensitivity and specificity was 0.846 and 0.677,the maximum Youden index YI was 0.513;no statistical significance was performed between the no carcinoma invasion areas and the normal gastric layers,each of the F and P value was 0.015 and 0.903,neither the slow ADC nor the mean F value between the carcinoma of the case group and the no carcinoma invasion areas and normal gastric layers demonstrated no statistical significance.Conclusion I.Multi-b values of biexponential model diffusion weighted imaging (IVIM-DWI) was demonstrated with reference value in the diagnosis of gastric carcinoma,fast ADC value can make a differentiate diagnosis of gastric adenocarcinoma and no carcinoma invasion areas with a non-invasive method which provide a significant reference for the pre-operative treatment options. II.No statistical significance demonstrated between the normal gastric layers of the control group and the no carcinoma invasion areas with fast ADC value. And the normal gastric layers’fast ADC value can stand as a reference to differentiate the gastric adenocarcinoma and no carcinoma invasion areas.Background The prognosis of gastric carcinoma is heavily related with pathologic grade,and accurate pre-operative pathologic grade is definitive important for the choice of appropriate treatment options.Grading of gastric carcinoma has been performed by endoscopic biopsy,however there still remains some risks and part of the patients can not tolerate the examination,so non-invasive method was urgently asked to asses the pathologic grade. Some researchers indicated that biexponential model diffusion weighted imaging (IVIM-DWI) can evaluate not only the microcirculation perfusion of the tissue but also the pathologic grade of the carcinoma.Objective To investigate the application value of biexponential model diffusion weighted imaging (IVIM-DWI) in differentiate the gastric carcinoma pathologic grade and to discus the relation between the different indexes and pathologic grade.Method We studied 32 patients with gastric adenocarcinoma which was proved by pathological examination,according to the pathologic grade,3 groups were classified as well-differentiated,differentiated and poor-differentiated in the correspondence with I level,Ⅱ level and III level.all the patients were conducted with a abdominal MRI examination with the sequence of axial and sagittal FSPGR T1WI, FSPROP T2WI, Multi-b values DWI. the MRI imaging was performed by using a 3.0-T MRI scanner (GE Discovery 750).each patient of 3 groups was measured with slow ADC, Fast ADC and f value of the carcinoma,the SNK-q and Spearman rank test was performed with the corresponding measurement value of well-differentiated,differentiated and poor-differentiated in the gastric adenocarcinoma,The ROC curve was depicted depended on the statistic mean value between the groups.Result The fast ADC value of poor-differentiated,differentiated and well-differentiated in the gastric adenocarcinoma was 11.277×10-3±0.00809mm2/s,23.269×10-3±0.018mm2/s, 28.205×10-3±0.0166 mm2/s respectively,ADC value of poor-differentiated was lower than well-differentiated and differentiated which demonstrated a statistical significance.F value between the two contrast groups was 19.191 and 43.411,P=0.000,and no statistical significance indicated between the differentiated and well-differentiated.the fast ADC value between poor-differentiated and well-differentiated was investigated to depict ROC curve,the area under the curve was 0.712,when the threshold was 11.08×l0-3mm2/s,the sensitivity and specificity was 0.815 and 0.519,the maximum Youden index YI was 0.334, the fast ADC value between differentiated and well-differentiated was investigated to depict ROC curve,the area under the curve was 0.793,when the threshold was 11.40×10-3mm2/s,the sensitivity and specificity was 0.852 and 0.520,the maximum Youden index YI was 0.372.slow ADC and F value demonstrated no statistical significance between the 3 groups,the Spearman rank test value of rs and p was 0.625 and 0.000 respectively.Conclusion I.Multi-b values of biexponential model diffusion weighted imaging (IVIM-DWI) with fast ADC value can asses the gastric adecarcinoma pathologic grade in a non-invasive method,and it is beneficial for both the prognosis of the gastric carcinoma patients and pre-operative choice of treatment options. Ⅱ.A postive correlation was indicated between the fast ADC value and the gastric adecarcinoma pathologic grade,but the correlation demonstrated not much intensity. |
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