Colorectal Cancer Specimens MRI In Vitro Combined With DEC-MRI In Vitro In Pathologic Comparison Analysis Of Rectal Cancer Lymph Node Metastasis

ObjectiveTo summary the metastasis signs of rectal cancer lymph node on High resolution MR and DWI and explore the accuracy of MRI examination of benign and malignant lymph node,and explore the value of dynamic contrast-enhanced magnetic resonance imaging(DCE- MR) in diagnosis the character of lymph node in mesorectum,to improve the accuracy of MRI on judge the character of lymph node before have an total mesorectal excision surgical operation.MethodsCollect 14 Patients with rectal cancer confirmed by pathological biopsy from Gansu Provincial hospital since June 2015 to November 2015.All patients were have an total mesorectal excision surgical operation,and all cases were performed by MR routine inspection,DWI and dynamic contrast-enhanced magnetic resonance imaging(DCE- MR) before surgical operation,and their specimens of colorectal cancer were examed by MR again.In which 8 patients were male,and 6 patients were female, aged from 49 to 72, average was 61.ResultsThere are 14 patients with rectal cancer were concluded in the study,specimens MRI were detected 112 lymph node and postoperative pathology examination found metastasis lymph nodes 22,reactive lymph nodes36, normal lymph node 53.Most metastasis lymph node is neither smooth edge,no uniform internal signals,compared with benign lymph nodes,the difference was statistically significant(P< 0.05).Most metastasis lymph node is neither smooth edge,no uniform internal signals, compared with benign lymph nodes,the difference was statistically significant, P values were less than 0.05.The short diameter of reactive hyperplastic lymph node and metastasis lymph nodes are(0.47-0.96)cm,(0.52-0.96)cm respectively, they are greater than normal lymph nodes(0.25-0.72)cm, the difference was statistically significant(P < 0.05), but the difference between the reactive hyperplastic lymph node and metastasis lymph nodes has no statistical significance(P > 0.05); The ratio of short diameter and length diameter are 0.855 ± 0.047 and 0.0273 ± 0.006, the difference was statistically significant(P< 0.05).The ADC values of metastatic lymph nodes is markedly lower than the normal lymph nodes[(0.722±0.047)×10-3mm2/s ∶(0..868±0.064)×10-3mm2/s], but with reactive hyperplastic lymph node(0.734±0.078)×10-3mm2/s was no significant difference.The Ktrans value of normal、reactive hyperplasticand metastasis lymph nodes were 0.145±0.020、0.208±0.022、0.247±0.036 respectively,the difference was statistically significant(P< 0.05);the Kep value were 0.479±0.133、0.624±0.105、0.681±0.121,the difference was statistically significant(P< 0.05);the Ve value were 0.333±0.076、0.382±0.093、0.362±0.087,the difference between them has no statistical significance(P > 0.05).ConclusionThe edge and internal signal of the lymph node within the rectal mesentery displayed clearly on High-resolution magnetic resonance imaging(MRI),it has high diagnostic value for the assessment of metastasis lymph node metastasis.DWI for distinguishing normal lymph nodes with metastasis lymph node has certain value, but to identify reactive hyperplastic lymph node lymph nodes with metastasis lymph nodes,has no significant means.The dynamic contrast-enhanced magnetic resonance imaging(DCE- MR) have confirmed significance on distinguish metastasis lymph nodes in mesorectum.