Non-invasive MR assessment of macroscopic and microscopic vascular abnormalities in the rectal tumour-surrounding mesorectum.
Eur Radiol
; 26(5): 1311-9, 2016 May.
Article
em En
| MEDLINE
| ID: mdl-26318370
ABSTRACT
OBJECTIVES:
To evaluate the MRI macroscopic and microscopic parameters of mesorectal vasculature in rectal cancer patients.METHODS:
Thirteen patients with rectal adenocarcinoma underwent a dynamic contrast-enhanced MRI at 1.5 T using a blood pool agent at the primary staging. Mesorectal macrovascular features, i.e., the number of vascular branches, average diameter and length, were assessed from baseline-subtracted post-contrast images by two independent readers. Mesorectal microvascular function was investigated by means of area under the enhancement-time curve (AUC). Histopathology served as reference standard of the tumour response to CRT.RESULTS:
The average vessel branching in the mesorectum around the tumour and normal rectal wall was 8.2 ± 3.8 and 1.7 ± 1.3, respectively (reader1 p = 0.001, reader2 p = 0.002). Similarly, the tumour-surrounding mesorectum displayed circa tenfold elevated AUC (p = 0.01). Interestingly, patients with primary node involvement had a twofold higher number of macrovascular branches compared to those with healthy nodes (reader1 p = 0.005 and reader2 p = 0.03). A similar difference was observed between good and poor responders to CRT, whose tumour-surrounding mesorectum displayed 10.7 ± 3.4 and 5.6 ± 1.5 vessels, respectively (reader1/reader2 p = 0.02).CONCLUSIONS:
We showed at baseline MRI of rectal tumours a significantly enhanced macrovascular structure and microvascular function in rectal tumour-surrounding mesorectum, and the association of primary mesorectal macrovascular parameters with node involvement and therapy response. KEY POINTS ⢠Vascular MRI reveals macrovascular and microvascular abnormalities in the rectal tumour-surrounding mesorectum. ⢠Formation of highly vascular stroma precedes the actual tumour invasion. ⢠High macrovascular parameters are associated with node involvement. ⢠Mesorectal vascular network differs for good and poor responders.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
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Imageamento por Ressonância Magnética
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Adenocarcinoma
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Malformações Vasculares
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article