Zheng Xin, Lu Tingyong, Tang Qiu, Yang Mao, Fan Yinfeng, Wen Ming
Chongqing Tongnan Hospital of traditional chinese medical, Chongqing, China.
First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Abdom Radiol (NY). 2025 Feb;50(2):598-607. doi: 10.1007/s00261-024-04536-w. Epub 2024 Aug 29.
This study aimed to evaluate the diagnostic performance of combining diffusion-weighted imaging (DWI) with T2-weighted imaging (T2WI) for detecting muscularis propria invasion in rectal cancer.
We conducted a retrospective analysis of MR images from 76 patients with pathologically confirmed rectal cancer between January 2018 and June 2022. Patients were categorized into invasion and non-invasion groups. the present of muscularis propria invasion. The examination regimen included T2WI, dynamic enhanced scanning and DWI.The apparent diffusion coefficient (ADC) values from DWI were compared between the groups, and the diagnostic performance of combining ADC with T2WI was assessed.
There were differences in ADCmean, ADCmsi, and ADCmin values between the non-invasion group and theinvasion group, and the t values were 3.949, 2.221 and 2.978, respectively. The P values were 0.000, 0.029 and 0.004, respectively. Using an ADC threshold of 1.07 × 10 mm²/s, the sensitivity and specificity for detecting muscularis propria invasion were 82.22% and 61.29%, respectively, with an overall diagnostic accuracy of 89.5%. For ADC, with a threshold of 0.996 × 10 mm²/s, the sensitivity and specificity were 62.75% and 73.33%, respectively, yielding a diagnostic accuracy of 82.9%. The ADC, with a threshold of 0.854 × 10 mm²/s, demonstrated sensitivity and specificity of 78.43% and 66.67%, respectively, with a diagnostic accuracy of 85.5%.
T2WI combined ADC value has a good predictive value for judging the degree of musculature invasion of medium-to-high rectal cancer, while ADC mean has a higher comprehensive diagnostic efficiency. Our finding may provide reference for increasing accuracy in mid-to-high rectal cancer diagnosis.
本研究旨在评估扩散加权成像（DWI）与T2加权成像（T2WI）相结合检测直肠癌肌层浸润的诊断性能。
我们对2018年1月至2022年6月期间76例经病理证实的直肠癌患者的磁共振图像进行了回顾性分析。将患者分为浸润组和非浸润组。存在肌层浸润情况。检查方案包括T2WI、动态增强扫描和DWI。比较两组之间DWI的表观扩散系数（ADC）值，并评估ADC与T2WI相结合的诊断性能。
非浸润组与浸润组之间的ADCmean、ADCmsi和ADCmin值存在差异，t值分别为3.949、2.221和2.978。P值分别为0.000、0.029和0.004。使用1.07×10⁻³mm²/s的ADC阈值，检测肌层浸润的敏感性和特异性分别为82.22%和61.29%，总体诊断准确率为89.5%。对于ADC，阈值为0.996×10⁻³mm²/s时，敏感性和特异性分别为62.75%和73.33%，诊断准确率为82.9%。ADC阈值为0.854×10⁻³mm²/s时，敏感性和特异性分别为78.43%和66.67%，诊断准确率为85.5%。
T2WI联合ADC值对判断中高位直肠癌肌层浸润程度具有良好的预测价值，而ADC均值具有较高的综合诊断效率。我们的发现可能为提高中高位直肠癌诊断的准确性提供参考。
