The application of multi b-value DWI combined with HR-T2WI in preoperative staging and circumferential resection margin evaluation of rectal cancer

GUO Xin; CHEN Fang; HUANG Congkun; BIAN Zhiwei; WANG Kang; ZHOU Kunsheng; ZHANG Chao

Abstract：Objective To explore the application value of multi b-value diffusion-weighted imaging(DWI)combined with high-resolution T2 weighted imaging(HR-T2WI)in preoperative staging and circumferential resection margin(CRM)evaluation of rectal cancer.Method Retrospective collection of clinical data was performed from 80 patients diagnosed with rectal cancer through histopathology,all of whom underwent preoperative multi b-value DWI and HR-T2WI examinations.The differences in apparent diffusion coefficient(ADC)among patients with different T,N stages,and CRM properties under multiple b-values were compared.Histopathological examination was used as the gold standard,Kappa consistency test was used to verify the con-sistency between the multi b-value DWI combined with HR-T2WI diagnostic results and histopathological diagnostic results.Re-sults There were 6 cases in T1 phase,20 cases in T2 phase,32 cases in T3 phase,and 22 cases in T4 phase;41 cases in N0 phase,23 cases in N1 phase,and 16 cases in N2 phase;49 cases were negative for CRM and 31 cases were positive.Under mul-tiple b values,the ADC of T1 patients was higher than that of T2,T3,and T4,and T2 was higher than T3 and T4.T3 was higher than T4,with statistical significant differences(P<0.05).Under multiple b values,the ADC of N0 patients was higher than N1 and N2,and N1 was higher than N2,with statistical significant differences(P<0.05).CRM negative ADC was higher than posi-tive,with statistical significant differences(P<0.05).HR-T2WI diagnosed 4 cases with T1 staging,22 cases with T2 staging,31 cases with T3 staging,and 23 cases with T4 staging.HR-T2WI detected 36 cases of N0 staging,28 cases of N1 staging,and 16 cases of N2 staging.According to the Kappa consistency test,there was a strong consistency between the HR-T2WI diagnostic T stage,N stage,CRM nature results and pathological histological results(Kappa=0.730,0.781,0.688,P<0.001).Multiple b-value DWI combined with HR-T2WI was used to diagnose 5 cases of T1 staging,23 cases of T2 staging,31 cases of T3 staging,and 21 cases of T4 staging.39 cases of N0 staging,24 cases of N1 staging,and 17 cases of N2 staging were diagnosed using multi b-value DWI combined with HR-T2WI.Conclusion The combination of multi b-value DWI and HR-T2WI has good diag-nostic value for preoperative staging and CRM properties of rectal cancer.