Abstract: Objective To evaluate the clinical application of high-field-strength magnetic resonance imaging to diagnose recurrent gastric cancer.Methods Forty three postoperative patients with gastric carcinoma were divided into two groups. The group with recurrent gastric carcinoma has 33 patients, they were clinically confirmed by barium meal of alimentary canal, CT or pathological results. There were 10 cases in control group confirmed by pathological results. All the subjects took hypotonicity agent, followed by water as negative contrast medium. Then patients underwent magnetic resonance imaging including fast spoiled gradient recalled T1WI, T2WI, diffusion weighted imaging, fast imaging employing steady state sequence, magnetic resonance cholangiopancreatographyand dynamic contrast enhancement sequences when gastrointestinal tract was in hypotonic, patients drank or were primed with water as contrast.Results Thirty patients were diagnosed as recurrent gastric cancer with MRI, 28 of them were confirmed by clinical results. Three patients were missed and two patients were incorrectly misdiagnosed by MRI. Wall thickness of gastric remnant was (4.5±0.3) mm and that of stomas was (6.3±1.4) mm in control group. Types of lesions were found on MRI:thickening of remnant stomach stomas was more than 8 mn(n=30), thickening of neighbor rem-nant stomach stomas was more than 5mm (n=19), mass of stomas (n=11), metastasis of neighbor viscus (n=5), and metastasis of lymph nodes (n=9). On enhancement scan, 9 patients showed inhomogeneous enhancement in arterial phase and 30 patients showed gradual delayed enhancement in venous phase and equilibrium phase.Conclusion MRI is an effective imaging method in illustrating wall thickness of gastric remnant and stomas, invasion depth by carcinoma, relationship with neighbor tissue structures and metastasis of lymph nodes and abdominal viscus. It plays an important role in directing clinical therapy.