The application value of MRI high-definition diffusion weighted imaging combined with T1WI dynamic contrast enhancement in preoperative T-stage of rectal cancer
10.3969/j.issn.1002-1671.2024.06.015
- VernacularTitle:MRI高清扩散加权成像联合T1WI动态对比增强在直肠癌术前T分期的应用价值
- Author:
Hongyan WAN
1
;
Xiangming FANG
;
Wei SHEN
;
Xiaoyun HU
;
Weiping ZHOU
;
Zhiqiang TIAN
;
Shudong YANG
;
Haixia MAO
;
Zongming ZHU
Author Information
1. 南京医科大学附属无锡人民医院医学影像科,江苏 无锡 214023
- Keywords:
diffusion weighted imaging;
dynamic contrast enhancement;
rectal cancer;
T-stage
- From:
Journal of Practical Radiology
2024;40(6):926-930
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effectiveness of high-definition diffusion weighted imaging(DWI)sequence combined with T1 WI-fat suppression(FS)dynamic contrast enhancement(DCE)sequence for preoperative T-stage of rectal cancer by using 3.0T MRI standardized scanning.Methods A retrospective analysis was conducted on MRI images of 57 patients with rectal cancer confirmed by pathology.Before surgery,the patients underwent 3.0T MRI standardized rectal cancer scan methods,including routine sequence,high-definition DWI sequence,and T1 WI-FS DCE sequence,etc.Then two experienced physicians evaluated the T-stage of preoperative rectal cancer through high-definition DWI(transverse and sagittal sections)and T1 WI-FS DCE sequences in the double-blind method.Using the postoperative pathological results of rectal cancer as the"gold standard",two sequences were combined to evaluate the accuracy,sensitivity,and specificity of rectal cancer T-stage.Results Among the 57 cases,there were 9 cases of upper rectal cancer,39 cases of middle rectal cancer,and 9 cases of lower rectal cancer.The accuracy rates of preoperative T-stage diagnosis for rectal cancer by two evaluator were both 85.7％(6/7)in T1 stage,88.2％(15/17)and 94.1％(16/17)in T2 stage,96.9％(31/32)and 93.8％(30/32)in T3 stage,and both 100.0％(1/1)in T4 stage.For evaluator 1,the sensitivity and specificity of the rectal cancer T-stage diagnosis were 96.1％and 83.3％,and for evaluator 2 were 94.1％and 83.3％,respectively.For rectal cancer MRI diagnosis,the accuracy rates and sensitivity were higher when combining the high-definition DWI sequence and T1 WI-FS DCE sequence,compared with a single high-definition DWI sequence or T1 WI-FS DCE sequence,and the difference was statistically significant.The average preoperative apparent diffusion coefficient(ADC)value of rectal cancer was compared between the corresponding postoperative pathological T1 to T4 stage groups,and the difference was statistically significant.Conclusion The combination of high-definition DWI sequence and T1 WI-FS DCE sequence improves the accuracy of rectal cancer T-stage,providing assistance for personalized clinical treatment.
