| ObjectiveTo compare the value of 3T magnetic resonance imaging(MRI)and computer tomography(CT)in preoperative T staging of potentially resectable esophageal cancer(EC).MethodsPatients with resectable EC diagnosed by clinic and pathological biopsy from May 2016 to December 2017 were collected.All patients underwent MRI(including T2WITSE-BLADE,DWI and Radial VIBE)and CT two days after the biopsy,CT were performed by plain and dynamic contrast enhanced scanning,MRI and CT were finished in two days,all patients received surgery within one week after MRI and CT scanning.The MR image quality was evaluated by two readers with more than 5 years experiences in the MRI diagnosis using a 5-point score separately.T staging was assigned on T2WI-TSE-BLADE +DWI?Radial VIBE?MRI(T2WI-TSE-BLADE + DWI + Radial VIBE)by the two MRI readers with one week interval between each evaluation method,the T staging of CT were evaluated by two CT readers,all of the CT and MRI readers used double-blind method in accordance with the 7th edition of AJCC TNM Classification for EC,and the inconsistent results between two MRI readers or two CT readers were discussed together with the third senior doctor and finally reached agreement,respectively.Considering postoperative pathological T staging results as the gold standard,the performances of T2WI-TSE-BLADE +DWI?Radial VIBE?MRI(T2WI-TSE-BLADE + DWI + Radial VIBE)and CT were evaluated based on the sensibility,specificity and accuracy rate,the accuracy rates of MRI and CT were analyzed by ?2 test.ResultsA total of 76 patients with EC were collected in the study from May 2016 to December 2017,20 cases without thin-slice reconstruction of CT,1 cases of postoperative pathology confirmed high grade intraepithelial neoplasia and 5 cases of patients without surgery were excluded,finally 50 cases were enrolled in the study.38 cases were male patients,12 cases were female patients.The youngest patient was 42 years old,and the oldest was 75 years old(59.38±7.73 years old).43 cases were squamous cell carcinoma,4 cases were adenocarcinoma,and 3 cases were neuroendocrine carcinoma.The pathological results revealed 17 cases with T1 staging,14 cases with T2 staging,14 cases with T3 staging,and 5 cases with T4 a staging.The good image quality cases(? 4 scores)were 46 in reader 1 and 44 in reader 2.The accuracy rates of T2WI-TSE-BLADE + DWI for T1-T4 a staging were 92.0%?84.0%?88.0%?94.0%.The accuracy rates of Radial VIBE for T1-T4 a staging were 98.0%?90.0%?86.0%?94.0%.The sensitivities of MRI for T1-T4 a staging were 94.1%?92.9%?85.7%?60.0%,the specificities of MRI for T1-T4 a staging were 100.0%?94.4%?91.7%?97.8%,the accuracy rates of MRI for T1-T4 a staging were 98.0%?94.0%?90.0%?94.0%.The sensitivities of CT for T1-T4 a staging were 54.5%?64.3%?71.4%?40.0%,the specificities of CT for T1-T4 a staging were 90.9%?77.8%?80.6%?88.9%,the accuracy rates of CT for T1-T4 a staging were 72.0%?74.0%?78.0%?84.0%.The number of exact staging cases in MRI and CT was 44 and 27,respectively.and the difference in accuracy rates between MRI and CT was statistically significant(?2=14.0,P<0.05).ConclusionsThe accuracy rate of MRI for preoperative T staging of EC is significantly higher than that of CT.MRI can be used as a noninvasive method for preoperative T staging of EC. |
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