The Valuation Of Assessment In Rectal Carcinoma Violated The Perirectal Space Using MR-DWIBS: Relationship With The Pathology

Objectives: Convention MRI combined with magnetic resonance diffusion weighted imaging with background suppression(MR-DWIBS) was used to study the characteristics of rectal carcinoma on MR images, and tried to analyze the condition of the invasion and metastasis cooperating with the relative apparent diffusion coeffient(ADC) and relative exponential apparent diffusion coeffient(e ADC). Simultaneously, we study the relationship between relative ADC value, relative e ADC value and PCNA, MMP-9, CD44v6 only to provide more accurate information for clinical treatment and prognosis.Methods: Collecting MRI and clinical data of sixty cases of rectal carcinoma proved by pathology. All the cases were diagnosed as rectal ulcer type intermediate differentiated adenocarcinoma, and the pathological stages are T2 or T3. A pelvic MRI scan including T1WI、T2WI、T2-SPAIR and DWIBS took place before the surgical operation, and an emphasis was taken on the imaging characteristics of the rectal carcinoma on DWIBS images. The sixty cases were divided into groups accoding to sex、pathological stages and lymphatic metastasis. Measure the ADC and e ADC value of the tumor region and musculi obturator internus and figure out the relative ADC and e ADC value. All data entered into computer and analyzed by SPSS17.0 software.The tumor tissue of thirty rectal carcinoma cases were conventional fixed, embedded and sectioned. The expression of PCNA、MMP-9 and CD44v6 of tumor tissues were detected by immunohistochemical staining,and the relationship between the relative ADC, e ADC and MMP-9, CD44v6 were analyzed.Results: The tumor region of rectal carcinoma was showed high signal intensity(“white”) in the original images and very lower signal intensity(“black”) in MR-DWIBS of black-white inversion. The ADC images showed lower signal intensity which means diffusion limitation. Statistical data showed no difference between male and female(P>0.05). Between the groups of lymphatic metastased or not, there was an significan difference in the value of the ADC、relative ADC and relative e ADC(P<0.05). Statistical data showed significantly different between the groups of involvement and not(P<0.05). The relative ADC value of rectal carcinoma was correlated negatively with the expression of PCNA、MMP-9 and CD44v6(rs =-0.747, P=0.000;rs =-0.683, P=0.000;rs =-0.620, P=0.000), and the relative e ADC value of rectal carcinoma was correlated positively with the expression of PCNA、MMP-9 and CD44v6(rs =0.725, P=0.000;rs = 0.689, P=0.000;rs = 0.580, P=0.001).Conclusions: MR-DWIBS has an important clinical value to determine the rectal carcinoma. The measurement of relative ADC and e ADC value of tumor tissues of rectal carcinoma can be noninvasive to assess the biological behavior of tumor.