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@#【Objective】To investigate the diagnostic value of multimodal intestinal MRI with routine MRI ，diffusion- weighted imaging（DWI）and multi-phase dynamic enhanced MR scanning by 3D-VIBE sequence in patients with ulcerative colitis（UC）.【Methods】Twenty-five patients with UC confirmed by endoscopic biopsy were enrolled. According to the modified Truelove-Witt′s criteria，patients were divided into remission group and active group，and the active group was divided into three subgroups as mild，moderate，and severe. The intestinal wall edema，comb sign，enlarged mesenteric lymph nodes，enhanced degree of intestinal wall，the maximum thickness of intestinal wall and the ADC value of the intestinal wall were observed and measured. The patient′ s C-reactive protein（CRP）and erythrocyte sedimentation rate （ESR）results were collected to evaluate the diagnostic value.【Results】The sensitivity and specificity in diagnosing the UC activity were not high by using CRP and ESR. There were significant differences in the stratification of intestinal wall edema ，comb sign ，intestinal wall thickness ，and ADC value between the four groups in the UC remission period and active period（P<0.05）. There were no significant differences between the four groups in mesenteric lymph nodes enlargement. ADC value had higher diagnostic efficiency for identification the activity group and remission group. Cutoff ADC values for differentiating the activity group and the remission group was calculated as（1.52 ± 0.16）× 10- 3 mm2/s，with 70.8% sensitivity and 79.8% specificity，respectively.【Conclusions】The diagnostic value of multimodal MRI for UC is higher than that of routine MRI，and multimodal MRI has high clinical value.
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<p><b>OBJECTIVE</b>To evaluate the diagnostic value of 3.0 T diffusion-weighted imaging with background suppression (DWIBS) magnetic resonance (MR) for lymph node metastasis in rectal cancer.</p><p><b>METHODS</b>Thirty-five patients with rectal cancer who underwent preoperative routine MRI+DWI examination were enrolled in the study and were treated by rectal cancer resection plus lymph node dissection. Metastatic and non-metastatic lymph nodes were confirmed by postoperative pathology. Apparent diffusion coefficient (ADC) values, long-axis and short-axis diameters of lymph nodes were measured. Receiver operating characteristic (ROC) curve was used to assess the diagnostic efficacy of ADC, long-axis and short-axis diameters for differentiating metastatic lymph nodes from non-metastatic lymph nodes.</p><p><b>RESULTS</b>A total of 151 lymph nodes were confirmed with exact location in 35 patients. Sixty-five metastatic lymph nodes and 86 non-metastatic lymph nodes were identified. The ADC values of metastatic lymph nodes and non-metastatic lymph nodes were(0.86±0.14)×10(-3) and (0.94±0.16)×10(-3) mm(2)/s respectively. The long-axis diameter were(9.78±3.13) and (7.90±1.77) mm, respectively. The short-axis diameter were (7.65±2.00) and (6.45±1.19) mm, respectively. There were statistically significant differences between metastatic and non-metastatic lymph nodes in ADC values, long-axis diameter, and short-axis diameter(all P<0.01). The areas under the ROC curve of ADC value, long-axis diameter, and short-axis diameter were 0.648, 0.706, and 0.692, respectively. Optimal cutoff values for these parameters were 1.05×10(-3) mm(2)/s, 7.95 mm, and 5.90 mm, respectively, and the corresponding sensitivities and specificities were 93.8% and 30.2%, 75.4% and 61.6%, 90.8% and 38.4%.</p><p><b>CONCLUSIONS</b>Quantitative measurement of ADC value may reflect the degree of diffusion restriction of metastatic lymph nodes by DWIBS at 3.0 T MR. Accurate diagnosis of metastatic lymph nodes in rectal cancer demands comprehensive evaluation combining ADC value with diameter measurement.</p>
Subject(s)
Humans , Diffusion Magnetic Resonance Imaging , Methods , Lymph Node Excision , Lymph Nodes , Pathology , Lymphatic Metastasis , Rectal Neoplasms , Diagnosis , PathologyABSTRACT
<p><b>BACKGROUND</b>Diffusion weighted imaging with background suppression (DWIBS) is potentially useful in detecting metastatic lymph nodes. This study aimed to evaluate the efficacy of DWIBS at 3T magnetic resonance (MR) for diagnosing metastatic lymph nodes in cervical cancer.</p><p><b>METHODS</b>This retrospective study included 25 patients with cervical cancer who underwent MR examination and were treated by hysterectomy and lymphadenectomy. The metastatic and non-metastatic lymph nodes were histologically proven by operation. Apparent diffusion coefficient (ADC) values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of all the identifiable lymph nodes were measured and compared.</p><p><b>RESULTS</b>Twenty-five primary tumor lesions, 17 metastatic lymph nodes and 140 non-metastatic lymph nodes were pathologically confirmed in 25 cases with cervical cancer. The difference of ADC values between primary tumor lesions, metastatic and non-metastatic lymph nodes were statistically significant (F = 7.93, P = 0.001). There was no statistically significant difference between primary tumor lesions of cervical cancer and metastatic lymph nodes (t = -0.75, P = 0.456), and the difference between primary tumor lesions and non-metastatic lymph nodes was statistically significant (t = 4.68, P < 0.001). The ADC values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of metastatic and non-metastatic lymph nodes were (0.86 ± 0.36) × 10(-3) mm(2)/s vs. (1.12 ± 0.34) × 10(-3) mm(2)/s, (1.51 ± 0.41) cm vs. (1.19 ± 0.36) cm, (1.16 ± 0.35) cm vs. (0.77 ± 0.22) cm, 0.78 ± 0.17 vs. 0.68 ± 0.19 respectively, and statistically significant difference existed between two groups.</p><p><b>CONCLUSIONS</b>DWIBS at 3T MR has the distinct advantages in detecting pelvic lymph nodes of cervical cancer. Quantitative measurement of ADC values could reflect the degree of restriction of diffusion of metastatic and non-metastatic lymph nodes. The combination of size and ADC value would be useful in the accurate diagnosis of metastatic lymph nodes.</p>