Evaluation of esophageal carcinoma in stage T1a, T1b and T2 with 3.0 T high-resolution MR imaging

Abstract

Objective To explore the value of 3.0 T high-resolution MR imaging in diagnosis of esophageal carcinoma in stage T1a,T1b and T2. Methods Thirty four esophageal specimens were obtained from 34 consecutive esophageal carcinoma patients, who had proven by gastroscopy biopsy preoperatively, and the postoperative specimens were scanned by MRI as pathological stage of T1a, T1b and T2. All specimens were scanned with high-resolution MR imaging within 30 minutes postoperatively followed by histopathological examinations immediately. A pathologist who was blind to MR findings identified the normal esophageal layers and carcinoma invasion of staging. The MR images reviewed by two radiologists, and then the MR staging compared with the histopathological examinations, and the histopathological results were served as a standard of reference. The Cohen's Kappa test was used to compare the stage of MR imaging with that of histopathological analysis. The sensitivity, specificity and accuracy of diagnostic efficacy were assessed by comparing with the histopathological findings. Results High-resolution MRI scan can clearly shows the normal wall of esophagus consist of eight layers which were consistent with histological anatomy. Thirty-one (91.2%) cases of MR staging were highly consistent with histopathological findings (Kappa= 0.863). The sensitivity, specificity and accuracy of high-resolution MR imaging for T1a staging were 5/6, 96.4%(27/28) and 94.1%(32/34), and T1b were 13/15, 19/19 and 94.1%(32/34), and T2 were 13/13, 95.2% (20/21) and 97.1(33/34), respectively. Conclusion High-resolution MR imaging has a great value in identifying esophageal layers in vitro and allowing precise assessment of carcinoma invasion, and which enable to distinguish the preoperative stage of T1a, T1b and T2 carcinoma. Key words: Esophageal neoplasms; Magnetic resonance imaging; Neoplasm staging