Application Of HR-MRI And DWI In Preoperative Staging Of Rectal Cancer

Objective:To investigate the value of 3.0T MRI HR-T2 WI and DWI sequences in preoperative evaluation of TN staging in rectal cancer.Methods: High-resolution MRI and diffusion-weighted imaging(DWI)scans were performed on patients with rectal cancer confirmed by colonoscopy to evaluate the TN stage of rectal tumors.HR-T2 WI and HR-T2WI+DWI two staging methods for preoperative rectal cancer were performed.Accuracy(Acc),sensitivity(Sen),specificity(Spe),positive predictive value(PPV),and negative predictive value(NPV)of each phase of TN staging were compared with those seen during surgery and postoperative pathological results.Spss21.0 software used Kappa test to evaluate the consistency of the two stages of HR-T2 WI and HR-T2WI+DWI and postoperative pathological staging,and to perform ROC curve analysis.Results:Acc,Sen,Spe,PPV and NPV of HR-MRI T staging and pathological staging of rectal cancer were T1:91.94%,80%,97.62%,80%,97.62%;T2: 87.23%,75%,91.43%,75%,91.43%;T3: 89.36%,88.46%.90.48%,92%,86.36%;T4:97.87%,100%,97.67%,80%,100%;Kappa test,Kappa=0.801,rectal cancer preoperative HR-MRI T stage and postoperative pathological stage consistency is excellent.ROC curve of preoperative T staging by HR-MRI(AUC=0.901,P=0.0001)Acc,Sen,Spe,PPV and NPV of HR-MRI+DWI T staging and pathological staging of rectal cancer were T1: 97.87%,100%,97.62%,83.33%,100%;T2:95.74%,91.67%,97.14%,91.67%,97.14%;T3: 95.74%,92.31%.100%,100%,91.3%;T4: 97.87%,100%,97.67%,80%,100%;Kappa test,Kappa=0.915,preoperative HR-MRI + DWI T staging and postoperative pathological stage consistency is excellent.ROC curve of preoperative T staging by HR-MRI+DWI(AUC=0.957,P=0.0001)Acc,Sen,Spe,PPV and NPV of HR-MRI N staging and pathological staging of rectal cancer were NO:78.72%,72.41%,88.89%,91.3%,66.67%;N1: 70.21%,64.29%,72.73%,50%,82.76%;N2: 87.23%,50%.90.7%,33.33%,95.12%.Kappa test,Kappa=0.521,preoperative HR-MRI N staging and postoperative pathologicalstage of the consistency,HR-MRI preoperative N staging ROC curve(AUC=0.761,P=0.0001)Acc,Sen,Spe,PPV and NPV of HR-MRI+DWI N staging and pathological staging of rectal cancer were NO: 82.98%,75.86%,94.44%,95.65%,70.83%;N1:78.72%,78.57%,78.79%,61.11%,89.66%;N2: 91.49%,75%.93.02%,50%,97.56%.Kappa test,Kappa=0.649,preoperative HR-MRI + DWI N staging and postoperative pathological staging consistency.ROC curve of preoperative N staging by HR-MRI+DWI(AUC=0.824,P=0.0001)Conclusions: 1.The HR-T2WI+DWI sequence and HR-T2 WI had good consistency in preoperative T staging and postoperative pathological staging of rectal cancer.The area under the ROC curve of HR-MRI+DWI sequence and pre-operative T stage of HR-T2 WI was 0.957 and 0.901.2.The HR-T2WI+DWI sequence had good consistency in the preoperative N staging and postoperative pathological staging of rectal cancer;preoperative HR-MRI had a consistency in preoperative MRI N staging and postoperative pathological staging of rectal cancer,HR-The area under the ROC curve of MRI+DWI sequence and preoperative N stage of HR-T2 WI was 0.824 and 0.761.3.HR-MRI+DWI sequence can provide more accurate preoperative TN staging for patients with rectal cancer.