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Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 14, 2007; 13(30): 4141-4146
Published online Aug 14, 2007. doi: 10.3748/wjg.v13.i30.4141
Assessment of T staging and mesorectal fascia status using high-resolution MRI in rectal cancer with rectal distention
Sheng-Xiang Rao, Meng-Su Zeng, Jian-Ming Xu, Xin-Yu Qin, Cai-Zhong Chen, Ren-Chen Li, Ying-Yong Hou
Sheng-Xiang Rao, Meng-Su Zeng, Cai-Zhong Chen, Ren-Chen Li, Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Medical Imaging Institute, Shanghai 200032, China
Jian-Ming Xu, Xin-Yu Qin, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Ying-Yong Hou, Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Meng-Su Zeng, MD, Department of Radiology, Zhongshan Hospital, Shanghai Medical Imaging Institute, 180 Fenglin Rd, Shanghai 200032, China. raoxrayct@gmail.com
Telephone: +86-21-64041990-2130
Received: February 27, 2007
Revised: March 3, 2007
Accepted: March 28, 2007
Published online: August 14, 2007
Abstract

AIM: To determine the accuracy of high-resolution magnetic resonance imaging (MRI) using phased-array coil for preoperative assessment of T staging and mesorectal fascia infiltration in rectal cancer with rectal distention.

METHODS: In a prospective study of 67 patients with primary rectal cancer, high-resolution magnetic resonance imaging (in-plane resolution, 0.66 × 0.56) with phased-array coil were performed for T-staging and measurement of distance between the tumor and the mesorectal fascia. The assessment of MRI was compared with postoperative histopathologic findings. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were evaluated.

RESULTS: The overall magnetic resonance accuracy was 85.1% for T staging and 88% for predicting mesorectal fascia involvement. Magnetic resonance sensitivity, specificity, accuracy, positive predictive value, and negative predictive value was 70%, 97.9%, 89.6%, 93.3% and 88.5% for ≤ T2 tumors, 90.5%, 76%, 85.1%, 86.4% and 82.6% for T3 tumors, 100%, 95.2%, 95.5%, 62.5% and 100% for T4 tumors, and 80%, 90.4%, 88%, 70.6% and 94% for predicting mesorectal fascia involvement, respectively.

CONCLUSION: High-resolution MRI enables accurate preoperative assessment for T staging and mesorectal fascia infiltration in rectal cancer with rectal distention.

Keywords: Magnetic resonance imaging; Rectum; Neoplasm; Staging; Mesorectal fascia