Diagnosis Of Preoperative T Staging Of Rectal Cancer By Multimodal MRI Imaging Technology

Objective:To explore the value of multimodal MRI(HR-T2 WI,IVIM,DCE)imaging technology in the diagnosis of preoperative accurate T staging of rectal cancer.Methods:A collection of 105 patients with rectal cancer diagnosed by colonoscopy and pathology in our hospital from December 2019 to February2021,of which 50 were eligible for enrollment,were 35 males and 15 females,with a median age of 62 years.According to whether or not to break through the muscularis propria,they are divided into 2 groups(non-breakthrough group and breakthrough group).Both groups received MRI routine,IVIM-DWI and DCE-MRI examinations.Among them,there were 20 cases in the non-breakthrough group(T1-2)and 30 cases in the breakthrough group(T3-4).The morphological features of the tumor(the distance between the lower edge of the tumor and the dentate line,the length of the tumor,the depth of invasion,the rectum,the mesangial fascia,the peritoneal reflex,and the peritumoral blood vessel)were evaluated by 3.0 T multi-parameter MRI HR-T2 WI before the operation.Compare with the functional nuclear magnetic parameters(measure the IVIM parameters D,D*,f and ADC values of the rectal wall of the non-breakthrough group and the breakthrough group and the DCE parameters Ktrans,Kep,Ve values)to compare the rectal wall of the non-breakthrough group and the breakthrough group at different T.The difference between the tumor parameters in the staging group,the analysis of IVIM parameters and DCE parameters in the T staging of rectal adenocarcinoma,respectively,and the combined diagnostic efficacy.Results:The parameter values of the tumors in the two groups were compared with those of the non-breakthrough group.The IVIM(D,D*,F,ADC)values of the breakthrough group were all decreased,and the DCE(Ktrans,Kep,Ve)values were all increased.Among them,D,ADC and Ktrans were scored.Becomes(0.871±0.120)×10-3mm2/s,(1.043±0.179)×10-3mm2/s,(0.238±0.413)/min;(0.710±0.181)×10-3mm2/s,(0.910±0.105)×10-3mm2/s,(0.307±0.650)/min,the difference is statistically significant(t=3.494,4.497,-4.172;p<0.05);Their respective AUC values were 0.859,0.818,0.888,and the combined AUC value of D value and Ktrans value was 0.950.The diagnostic effect of D value,Ktrans value and the Joint factor is very good,and the ADC value effect is average(0.5-0.7 has a low effect,0.7-0.85 has a fair effect,0.85-0.95 has a good effect,and 1 has a perfect effect);The cutoff value of D value is 0.732,Youden value is 0.683;the cutoff value of ADC value is 0.925,Youden value is 0.533;the cutoff value of Ktrans value is0.250,Youden value is 0.633;The cutoff value of K-D joint factor is 8.819,Youden value is 0.833.HR-T2 WI,IVIM parameter value D,the DCE Ktrans parameter values,combined factors KD Evaluation colorectal cancer before surgery precise overall accuracy of the T stage,the sensitivity and specificity were 90%,80%,78%,98%;89.4 %,67.8%,80.0%,95.2%;90.3%,95.4%,77.1%,100%.Conclusion:The parameter with the greatest diagnostic efficiency is the K-D combined factor,followed by Ktrans;the largest Youden value is the K-D combined factor,followed by the D value;the overall diagnostic accuracy is the best K-D combined factor,followed by HR-T2 WI.Each parameter value in f MRI diagnosis tree decision-making is K-D joint factor,Ktrans,D,ADC in descending order.The morphological features of conventional sequences have their own limitations.The introduction of functional sequences(IVIM-DWI,DCE-MRI)has a certain complementary value for the accurate T staging diagnosis of rectal cancer.The combination of the two can effectively improve the accuracy of the accurate T staging diagnosis of rectal cancer.To optimize preoperative decision-making for patients.