MR Whole Abdominal Examination In Rectal Cancer:Preoperative And Prognosis Research

Objective To investigate the value of MR whole abdominal examination diagnosed rectal cancer, and the quantitative parameters of the diffusion weighted imaging (DWI) correlation coefficient of apparent diffusion coefficient (ADC) with rectal cancer prognostic factors.Methods A retrospective analysis of47patients by biopsy or operation with pathologically confirmed underwent MR whole abdominal examination before surgery and adjuvant therapy. Fully observed in all patients image data to determine the preoperative staging of MRI (with or without mesorectal fascia (MRF) invasion; the MR T; MR N; MR M staging), the key observation abdominal and pelvic lymph nodes and distant organ metastasis. Rectal tumor ADC values in accordance with the preoperative staging of MRI, gross type, tumor site and histological factors (the degree of tumor differentiation:poorly differentiated, moderately differentiated, well-moderately differentiated, well-differentiated) grouping of cases, analysis of tumor ADC value of MRI before surgery stage, histological type of organization, carcinoembryonic antigen (CEA) level, tumor location, age, gender relations.ResultMR whole abdominal examination observation result:47patients MR abdominal examination were detected suspicious liver metastasis in12cases; abdomen suspicious lymph node metastasis in10cases, suspicious pelvic lymph node metastasis in30cases, lung metastases in1case.47cases of patients with rectal cancer,5patients did not undergo surgery;42patients after surgery, to control surgical findings and pathological findings confirmed:17cases of pelvic lymph node metastases,6patients presented with abdominal lymph node metastases;4patients withnot confirmed lymph nodes named Nx; intraoperative findings of peritoneal metastasis in2cases, the MR examination failed to observed clear signs of peritoneal metastasis.12patients with suspected liver metastasis, four cases were confirmed by surgery;5cases of liver metastases;1cases were confirmed by surgery for hemangioma;2cases of the proposed enhanced scan.The mean ADC value of rectal cancer tumor MRF-free and MRF invasion (p=0.039), MR NO MR N1-2(p=0.01) were significantly different. The mean ADC value of the tumor and the degree of tumor differentiation, CEA level, MR T, MR M staging, tumor gross type, tumor location, gender, age had no significant correlation.Conclusion1. MR whole abdominal examination combined with DWI are possible to accurately observe the rectal anatomy, evaluation of clinical T, Clinical N staging, comprehensive observation of early detection of sporadic colorectal cancer distant metastasis and abdominal lymph node metastases, and enhance the accuracy of clinical N and Clinical M staging. MR abdominal examination can improve the preoperative diagnosis, staging, treatment plan, useful to assessment prognosis.2. Significant correlations were found between mean ADC values and radiological MRF status, N stage. ADC has the potential to become an imaging biomarker for prompt tumor aggressiveness profile and evaluation of tumor prognosis.