A Study Of Application Value Of MRI Multi-b Values DWI On The Esophageal Squamous Cell Carcinoma Diagnosis

Objective: To explore the application value of multi b-value diffusion weighted imaging in differentiate the esophageal squamous cell carcinoma and no cancer infiltration wall with the ADC values.Methods: 47 patients with infiltration were included as the case group and 11 healthy volunteers were recruited as the control group. Adopting Discovery MR 750 3.0 T, all subjects received conventional MR and DWI examinations. Multi-b values were included 0, 300, 500, 800, 1000 s/mm2. Using respiratory gating and ECG-gating, scanning range covered the whole length of the esophagus. Apparent diffusion coefficient(ADC) values of multi-b values of the cancer areas, no cancer invasion areas each patient of the case group and the normal esophagus layers of the control group, and dorsal muscle of both groups were calculated in the workstation, respectively. SNK-q test was conducted between the normal esophagus wall, dorsal muscle of both groups and the case group’s cancer and no cancer invasion areas according to the research objective, respectively. P value of less than 0.05 was considered to represent a significant difference.Results: The mean ADC values of cancer areas of each b-value were lower than that of no cancer invasion areas and normal esophagus wall. Both of the P values were 0.000 with statistical significance. No cancer invasion areas and normal esophagus wall were of no statistical significance under each b value. The difference of ADC values of back muscles and the tumor areas were not stable, and of no statistical significance. When b-value was 800 s/mm2, the ADC values were closer to the true values, and with the higher images quality, larger area under the ROC curve, and higher specificity and sensitivity.Conclusions: DWI multi-b values were demonstrated with reference value in the diagnosis of esophageal squamous cell carcinoma. The ADC value can make a differentiate diagnosis of esophageal squamous cell cancer and no cancer invasion areas with non-invasive method which can provide a significant reference or the treatment options. No statistical significance demonstrated between the normal esophagus wall of the control group and no cancer invasion areas with the ADC value. And the ADC values of normal esophagus wall can stand as a reference to differentiate the esophageal squamous cell carcinoma and no cancer invasion areas. The ADC values of dorsal muscles are of no meaning in diagnosing esophageal squamous cell carcinoma. At 3.0 T, esophageal squamous cell carcinoma can be best visibled on b=800 s/mm2,they can be better to reflect the character of hydrone diffusion of Esophageal squamous cell carcinoma.Objective: To investigate the application value multi-b value diffusion weighted imaging in differentiate the esophageal squamous cell carcinoma pathologic grade and to discuss the relation between the different indexes and pathologic grade.Methods: We studied 47 patients with esophageal squamous cell carcinoma which was proved by pathological examination, according to the pathologic grade, 13 well-differentiated, 22 middle-differentiated and 12 poor-differentiated. Adopting Discovery MR 750 3.0 T, all subjects received conventional MR and DWI examinations. Multi-b values were included 0, 300, 500, 800, 1000 s/mm2. Using respiratory gating and ECG-gating, scanning range covered the whole length of the esophagus. Apparent diffusion coefficient(ADC) values of multi-b values of the cancer areas were calculated in the workstation, respectively. SNK-q test was performed with the corresponding measurement value of well-differentiated, middle-differentiated and poor-differentiated in the esophageal squamous cell carcinoma.Results: The ADC values of poor-differentiated were lower than well-differentiated and middle-differentiated, the poor-differentiated and poor-differentiated were of statistical significance in each b-values. The well-differentiated and middle-differentiated demonstrated a statistical significance when b=800 s/mm2. The poor-differentiated and middle-differentiated demonstrated no statistical significance in each b-values.Conclusion: The ADC values of multi-b value diffusion weighted imaging can assess esophageal squamous cell carcinoma pathological grade in a non-invasive method. A certain negative correlation was indicated between the ADC value and the esophageal squamous carcinoma pathologic grade, therefore, multi-b value of DWI ADC values can be used as an imaging evaluation of esophageal squamous cell carcinomas that basis on pathological grading.