Differential Diagnosis of Rectum Endometriosis and Rectal Carcinoma Based on Multimodal Magnetic Resonance Imaging
Objective To explore the application value of multimodal magnetic resonance imaging(MRI)in the differentiation of rectal endometriosis and rectal carcinoma.Methods Sixteen patients with pathologically proven rectal endometriosis and eighteen patients with rectal carcinoma underwent MRI,diffusion weighted imaging(DWI)and dynamic contrast-enhanced MRI,which were retrospectively reviewed.The MR signals,time-signal intensity curve(TIC)type,maximum contrast enhancement ratio(MCER),mean apparent diffusion coefficient(ADC)values,and relative ADC(rADC)values of each case were analyzed and calculated.Receiver operating characteristic(ROC)curve analysis,Cohen's d effect size,and the Youden index were used to assess the differential diagnostic ability of the quantitative indicators(MCER,ADC,and rADC).Results Both rectal endometriosis and rectal carcinoma showed stenosis of the intestinal lumen,heterogeneous thickening of the intestinal wall,and involvement of adjacent structures.The difference was that short T2 signals were seen within almost half of the rectal endometriosis lesions,accompanied by the characteristic"mushroom cap"sign and"submucosal edema"sign.The most common TIC curve was type Ⅰ in patients with rectal endometriosis,while the majority of the curves were types Ⅱ in patients with rectal carcinoma.MCER,ADC,and rADC were statistically significantly different between groups(P＜0.001).The MCER values of rectal endometriosis were significantly lower than those in rectal carcinoma,but the ADC and rADC values were significantly higher.Among these factors,ADC revealed the most reliable diagnostic performance,followed by rADC and MCER.Conclusion The combination of multimodal MRI could effectively distinguish rectal endometriosis from rectal cancer and help to avoid clinical misdiagnosis.
magnetic resonance imagingrectal carcinomarectumendometriosis
万方数据
维普
