目的 探讨磁共振成像(MRI)与 多层螺旋CT(MSCT)对胃癌术前N分期及淋 巴结转移的诊断价值。方法 回顾性分析 行术前MRI、MSCT检查的39例胃癌手术 患者临床资料，以术后病理结果为金标 准，分析MRI与MSCT诊断胃癌淋巴结转移 的价值，比较转移淋巴结与非转移淋巴 结影像特点。结果 MRI对胃癌N1、N2、 N3a、N3b分期诊断准确度及总准确度分别 为66.67%、88.89%、70.00%、57.14%、 71.79%，Kappa值为0.609；MSCT对胃癌 N1、N2、N3a、N3b分期诊断准确度及总准 确度分别为33.33%、66.67%、90.00%、 71.43%、76.92%，Kappa值为0.621；两种 检查方法诊断准确度比较差异无统计学意 义(P>0.05)，且均与术后病理结果有较好 一致性。MRI或MSCT下胃癌转移淋巴结短 径、长径与与非转移淋巴结无统计学差异 (P>0.05)，转移淋巴结rADC值明显低于 非转移淋巴结(P<0.05)，强化程度明显 高于非转移淋巴结，差异有统计学意义 (P<0.05)。结论 MRI与MSCT均对胃癌术前 N分期有较高诊断价值，DWI中rADC值及 MSCT强化程度可作为判断淋巴结性质的重 要指标。

Objective To discuss the value of magnetic resonance imaging (MRI) and multislice spiral CT (MSCT) in the diagnosis ofpreoperative N staging and lymph node metastasis of gastric cancer. Methods The clinical data of 39 patients with gastric cancer examined by MRI and MSCT before operation were retrospectively analyzed. With postoperative pathological resultsas the golden standard, the value of MRI and MSCT in the diagnosis of lymph node metastasis of gastric cancer was analyzed. The imaging features of metastatic lymph nodes and non-metastatic lymph nodes were compared. Results The accuracy, total accuracy and Kappa valueof MRI in the diagnosis ofN1, N2, N3a and N3b stages of gastric cancer were 66.67%, 88.89%, 70.00%, 57.14%, 71.79% and 0.609 respectively, while those of MSCTwere 33.33%, 66.67%, 90.00%, 71.43%, 76.92% and 0.621 respectively.There was no statistically significant difference in the diagnostic accuracy between the two methods(P>0.05), and both of them were in good consistencywith the postoperative pathological results. There were no statistically significant differences in the short diameter or the long diameter between metastatic lymph nodes and non-metastatic lymph nodes diagnosed by MRI or MSCT (P>0.05), and the rADC value of metastatic lymph nodes was significantly lower than that of non-metastatic lymph nodes (P<0.05), and the degree of enhancement was significantly higher than that of non-metastatic lymph nodes (P<0.05). Conclusion Both MRI and MSCT are of high diagnostic value for preoperative N staging of gastric cancer. The rADC value in DWI and the enhancement degree of MSCT can be used asimportant indexes to determine the properties of lymph nodes.