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Preoperative MRI of Rectal Cancer With and Without Rectal Water Filling: An Intraindividual Comparison

 Myeong-Jin Kim  ;  Joon Seok Lim  ;  Ki Whang Kim  ;  Won Ho Kim  ;  Kang Young Lee  ;  Nam Kyu Kim  ;  Seung Ho Joo  ;  Jae-Joon Chung  ;  Joo Hee Kim  ;  Young Taik Oh 
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.182(6) : 1469-1476, 2004 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Magnetic Resonance Imaging*/statistics & numerical data ; Male ; Middle Aged ; Neoplasm Staging ; Observer Variation ; Preoperative Care ; Rectal Neoplasms/pathology* ; Reproducibility of Results ; Single-Blind Method ; Water
OBJECTIVE: The purpose of our study was to determine if a rectal distention using warm water may improve the accuracy of MRI for the preoperative staging of rectal carcinoma. SUBJECTS AND METHODS: Sixty-two patients with surgically proven rectal carcinomas underwent pelvic MRI before and after a rectal distention by warm water. Four radiologists, who were blinded to the study, reviewed each set of T1- and T2-weighted axial images obtained before and after the rectal distention and scored the image of the tumor. The accuracies for determining the tumor penetration of the outer wall of the rectum and the regional lymph node involvement were compared by analyzing the area under the receiver operating characteristic curve (A(z)). RESULTS: For all reviewers, the tumor depiction scores were significantly higher in the distended images (3.8-3.9 for reviewers 1-4) than in the nondistended images (3.0-3.2) (p < 0.01). For determining the outer wall penetration, the accuracy of the three reviewers was significantly higher with the rectal distention images than with the nondistended images (p < 0.05). The mean accuracy of the all reviewers was significantly better with the distended images (A(z) = 0.922) than with the nondistended images (A(z) = 0.841) (p < 0.05). For determining the presence of regional lymph node involvement, all the reviewers came to similar conclusions in analyzing the two image sets. CONCLUSION: Rectal distention by water filling may improve the depiction of a primary rectal tumor and the assessment accuracy of a perirectal tumor extension, but it does not improve the accuracy for determining the presence of regional lymph node involvement.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Oh, Young Taik(오영택) ORCID logo https://orcid.org/0000-0002-4438-8890
Lee, Kang Young(이강영)
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
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