The Application Value Of DWI Combining With DCE-MRI In Preoperative Diagnosis And Grading Of Rectal Cancer

Objective:1? To investigate the application value of apparent diffusion coefficient?ADC?combining with time-intensity curve parameters(TIC parameters: T_peak?SI_peak?E_max)in the preoperative diagnosis of rectal cancer.2?To analyze the value of ADC in grading of rectal cancer by studying the correlation between ADC and differentiation grade of rectal adenocarcionma.3?To explore the relationship between TIC parameters(T_peak?SI_peak?E_max)and tumor grading,and to analyze the value of TIC parameters in histological differentiation grade of rectal cancer.Material and Methods:The DWI characteristics of 58 patients and 32 nomal person in Shanxi Academy of Medical Sciences Shanxi Dayi Hospital from January 2015 to January 2017.Postoperative pathology showed 18 cases of highly differentiated adenocarcinoma,moderately differentiated adenocarcinoma in 26 cases,and poorly differentiated adenocarcinoma in 14 cases.The mean ADC value was measured from two different factors?0 and 800 s/mm²?by Philips Achieva 3.0TMR workstation.Compared the differences among the different groups and analyze the relationship between ADC value and the differentiated degree of tumor.36 patients were scanned by DCE-MRI.There were 10 highly differentiated adenocarcionma,18 mederately differentiated adenocarcionma,8 poorly differentiated adenocarcionma.The normal rectal wall group had 36 cases.The TIC curve was drawn on the workstation and the TIC parameters(T_peak?SI_peak?E_max)were recorded.Compared the differences among the different groups and analyze the relationship between TIC parameters and the differentiated degree of tumor.Results:The mean ADC for highly differentiated group was?0.51�0.02?�10^-3mm²/s,andthe mean ADC for moderately differentiated group was?0.47�0.02?�10^-3mm²/s whereas that for poorly differentiated group was?0.40�0.03?�10^-3mm²/s.The mean ADC value of the three groups was significantly different?P < 0.05?.The ADC value and the differentiated degree of tumor were negatively correlated?Spearmanr=-0.864?P<0.01.The average ADC of rectal adenocarcinoma group was?0.46�0.05?�10^-3mm²/s.The average ADC of the nomal group was?0.53�0.01?�10^-3mm²/s.The difference of ADC?T_peak?SI_peak?E_max between the tumor group and the healthy group?P<0.05?.The average T_peak?SI_peak and E_max in rectal cancer group were 83.88�15.75?3620.85�131.21?2591.57�90.53.The T_peak ? SI_peak and E_max of nomal rectal wall group were 204.70�29.48 ?1290.52�237.49?952.96�222.26.The T_peak?SI_peak and E_max of the highly differentiated group,the moderately differentiated group,and the poorly differentiated group were shown in Table 6.T_peak and the differentiated degree of tumor were negatively correlated?Spearman=0.526?P<0.05;The difference between highly differentiated group and poorly differentiated group was statistically significant?P<0.05?.The difference between highly differentiated between moderately differentiated group and poorly differentiated group was statistically significant?P<0.05?.SI_peak?E_max and the differentiated degree of tumor weren't correlated.However,with the decrease of differention there was an increasing trend.The tumor group's TIC curve was ourflow type,and the nomal group was inflow or platform type.Conclusion:1?ADC and TIC parameters have the value of differential diagnosis in recal cancer.2?ADC can be used to judge the differentiation grade of rectal adenocarcionma T_peak can reflect the differentiation grade of rectal cancer to some extent,but it is not effective.SI_peak?E_max can indirectly reflect the biological information of tumor but have limitation;The relationship between TIC parameters and the differentiation grade need further study.