Diffusion Weighted Imaging in Evaluating the Prognosis of Colorectal Cancer Patients with Regional Lymph Node Metastasis
10.3969/j.issn.1005-5185.2015.07.010
- VernacularTitle:扩散加权成像评估结直肠癌区域淋巴结转移预后相关因素分析
- Author:
Sen ZHANG
;
Yu KANG
;
Xiangke DU
- Publication Type:Journal Article
- Keywords:
Colorectal neoplasms;
Lymphatic metastasis;
Prognosis;
Magnetic resonance imaging;
Diffusion weighted imaging
- From:
Chinese Journal of Medical Imaging
2015;(7):513-516,522
- CountryChina
- Language:Chinese
-
Abstract:
PurposeDiffusion weighted imaging (DWI) can significantly improve the diagnosis of non-enlarged lymph node metastasis. This study aims to evaluate the correlation between the DWI findings and the prognosis, and to identify prognostic factors.Materials and Methods Forty-seven patients with colorectal cancer underwent MRI scan including DWI sequence before surgery. Imaging ifndings were compared with the pathologic results to determine the metastatic lymph nodes (DWI positive) or non-metastatic lymph nodes (DWI negative). Postoperative disease-free survival and overall survival for 5 years of the patients with DWI positive and DWI negative lymph nodes were compared. Correlation between the prognosis and the related factors were investigated including regional DWI-positive lymph nodes, short axis diameter and long axis diameter of the largest DWI-positive lymph node, and number of DWI-positive nodes.Results Of 47 patients,10 (21%) patients had regional DWI-positive lymph nodes showed high signal intensity on diffusion-weighted images. The patients with regional DWI negative lymph nodes had a signiifcant better ifve-year disease-free survival and overall survival (P<0.05). The short axis diameter of the largest DWI-positive lymph node was correlated with distant metastasis (AUC=0.77,P<0.05). The short axis diameter and long axis diameter of the maximum metastatic lymph nodes were correlated with overall survival (AUC=0.84 and 0.75,P<0.05). Five-year disease-free survival and overall survival of the patients with short axis diameter of the largest DWI-positive lymph node ≤9 mm were higher than the patients with lymph node short axis diameter >9 mm (P<0.05). Five-year disease-free survival and overall survival of the patients with long axis diameter of the largest DWI-positive lymph nodes ≤11 mm were higher than the patients with long axis diameter >11 mm (P<0.05). Five-year disease-free survival of the patients with all DWI positive lymph nodes resected was higher than the patient without DWI-positive lymph nodes resected (P<0.05).Conclusion The patients with regional DWI-negative lymph node had a better prognosis. Of the patients with DWI-positive lymph nodes, the patients with smaller lymph nodes have better prognosis than who have larger lymph nodes.
