目的 探讨MRI平扫与体素内不相 干运动模型(IVIM)对食管胃结合部腺癌 术前T分期及病理分化程度评估的诊断价 值。方法 前瞻性研究经内镜证实为食管 胃结合部癌，且最终行手术治疗获得病理 结果的47例患者的临床和影像资料。所 有患者术前一周内行MRI平扫及IVIM成像 检查。将IVIM原始图像传至GE AW 4.6后 处理工作站。手动勾画感兴趣区(ROI)， 计算表观扩散系数(ADC)、真实扩散系数 (D)、灌注相关扩散系数(D*)和灌注分数 (f)。MRI平扫结合IVIM与手术病理T分期 的结果一致性分析采用Kappa检验。结果 47例患者MRI平扫结合IVIM术前T分期准确 率分别为：T1期71.43%，T2期75.00%， T3期88.24%，T4期93.33%，总体准确率 为85.11%。食管胃结合部腺癌不同病理 分级间的ADC值与D值差异均有统计学意 义(P<0.05),D*及f值差异无统计学意义 (P>0.05)。结论 MRI平扫结合IVIM检查对 食管胃结合部腺癌术前T分期及病理分化 程度的评估具有重要临床指导意义。

Objective To prospectively determine the diagnostic performance of 3.0T magnetic resonance imaging (MRI) routine sequence combined with intravoxel incoherent motion (IVIM) models in diagnosis of preoperative T staging and differentiating the pathological differentiated grade of esophagogastric junction adenocarcinoma. Methods Prospective study of 47 cases of patients with newly diagnosed adenocarcinoma of esophagogastric junction confirmed by electronic digestive tract endoscopy and surgical pathology results. All patients received conventional MRI plain scan and IVIM examination one weeks before operation. The images of IVIM were imported into the GE AW 4.6 workstation. Freehand ROI was used to cover the whole tumor volume, ADC, D, D* and f was calculated. Kappa consistency test was used to assess the consistency of T staging between the two methods. Results The accuracy of 3.0T magnetic resonance imaging (MRI) routine sequence combined with IVIM-DWI MRI for T stages was 85.77%, 71.43% for T1, 75% for T2, 88.24% for T3 and 93.33% for T4 and respectively. The ADC and D values had significant difference among the different histologic grade of AEGs (P<0.05), while the D* and f values had no difference(P>0.05). Conclusion 3.0T magnetic resonance imaging (MRI) routine sequence combined with intravoxel incoherent motion (IVIM) models has great significance for preoperative assessment of T staging and differentiating the pathological of esophagogastric junction adenocarcinoma.