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Gastrointestinal Imaging |
1 From the Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (S.M.H., E.K.O.); the Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (S.M.H.); and the Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, Pa (E.S.S.). Received May 29, 1998; revision requested June 19; final revision received December 21; accepted April 8, 1999. S.M.H. supported in part by the Dutch Cancer Society, Amsterdam, the Netherlands. Address reprint requests to E.K.O., Department of Radiology, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724-5067 (e-mail: outwater@radiology.arizona.edu).
PURPOSE: To determine if quantitative and qualitative magnetic resonance (MR) imaging measures can help differentiation of mucinous from nonmucinous rectal tumors.
MATERIALS AND METHODS: In 26 patients with pathologically proved mucinous (n = 9) and nonmucinous (n = 17) rectal tumors, MR imaging was performed with T1-weighted spin-echo (SE) and T2-weighted fast SE sequences in all patients and with a gadolinium-enhanced T1-weighted sequence in 18. With use of the signal intensity (SI) measurements in the tumors and reference tissues, tumor-to-muscle, tumor-to-fat, and tumor-to-urine SI ratios were calculated. In addition, the SI and contrast-enhancement patterns in the tumors were assessed qualitatively by three blinded readers.
RESULTS: Mucinous tumors had a much higher SI on the T2-weighted fast SE images. Tumor-to-muscle, tumor-to-fat, and tumor-to-urine SI ratios were significantly higher in the mucinous compared with the nonmucinous tumors (P = .0004, P = .0008, and P = .00002, respectively). Qualitative evaluation of the SI correlated well between readers 1 and 2 (r = 0.93), readers 1 and 3 (r = 0.94), and readers 2 and 3 (r = 0.91). Agreement for the contrast-enhancement patterns was 67%, 72%, and 67%, respectively, with most mucinous tumors having predominantly high SI and a peripheral contrast-enhancement pattern.
CONCLUSION: Mucinous and nonmucinous rectal tumors can be differentiated with MR imaging because mucinous tumors show high SI on T2-weighted fast SE images.
Index terms: Magnetic resonance (MR), rapid imaging, 757.12146 • Magnetic resonance (MR), tissue characterization, 757.121411, 757.121412, 757.12146, 757.12143 • Rectum, MR, 757.121411, 757.121412, 757.12143 • Rectum, neoplasms, 757.321
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