Abstract:

Objective To explore the value of applying functional magnetic resonance imaging (MRI) and CT imaging to T staging of esophageal cancer. Methods Fifty-four patients with esophageal cancer who planned to undergo surgery were selected as subjects and received chest CT and MRI examination. The diagnostic value of diffusion weighted imaging (DWI) combined with high resolution T2-weighted imaging (HR-T2WI), HR-T2WI alone, and CT for T staging of esophageal cancer was compared according to postoperative pathological results. Results Of 54 patients, 1 had double primary lesions, 49 had squamous cell carcinoma, 1 had adenocarcinoma, 1 had poorly differentiated neuroendocrine carcinoma, and 4 had carcinoma in situ or high atypical hyperplasia. For T1-T4 stage of esophageal cancer, the accuracies of DWI combined with HR-T2WI, HR-T2WI alone, and CT for determining the stage were 89.1% (49/55), 83.6% (46/55), and 67.3% (37/55), respectively. The differences between DWI combined with HR-T2WI and CT, and HR-T2WI alone  and CT were statistically significant (P=0.005，P=0.038). For T1-T2 staging (including Tis stage) of esophageal cancer, the accuracies of the three methods were 70.6% (12/17), 64.7% (11/17), and 29.4% (5/17), respectively. The differences between DWI combined with HR-T2WI and CT, and HR-T2WI alone and CT were statistically significant (P=0.019，P=0.042). For T3-T4 staging of esophageal cancer, the accuracies of the three methods were 97.4% (37/38), 92.1% (35/38), and 84.2% (32/38), respectively. The differences between DWI combined with HR-T2WI and CT, and HR-T2WI alone and CT were not statistically significant. Conclusion The accuracy of DWI combined with HR-T2WI for diagnosing the T staging of esophageal cancer is better than that of CT, especially for patients with T1-T2 stage (including Tis stage) of esophageal cancer.

Key words: esophageal carcinoma, magnetic resonance imaging, diffusion weighted imaging, CT, T Staging