Diffusion-weighted imaging of the rectosigmoid colon: preliminary findings.
OBJECTIVE
The aims of this study were to determine and evaluate the apparent diffusion coefficient (ADC) values of the rectal wall for identifying inflammatory bowel disease (IBD) and rectosigmoid (rectum and sigmoid colon) malignancies.


METHODS
Diffusion-weighted magnetic resonance imaging (DWI) findings of 23 patients (mean age, 57 years) consisting of 14 patients with rectosigmoid adenocarcinomas and 9 patients with IBD (6 with ulcerative colitis and 3 with Crohn disease) were retrospectively reviewed. In addition, 30 healthy controls (mean age, 45 years) were enrolled in the study. Diffusion-weighted imaging was performed with b factors of 0, 500, and 1000 s/mm2.


RESULTS
The mean (SD) ADC values of the control, IBD, and rectosigmoid adenocarcinoma groups were 1.47 (0.19) x 10(-3) mm2/s, 1.37 (0.12) x 10(-3) mm2/s, and 0.97 (0.14) x 10(-3) mm2/s, respectively. Among the patients with IBD, 2 were in the active, and the rest were in the inactive period, with mean (SD) ADC values of 1.21 (0.08) x 10(-3) and 1.42 (0.09) x 10(-3), respectively. The ADC values of the normal rectum and rectosigmoid malignancy group and rectosigmoid carcinoma and IBD groups were significantly different (P < 0.01). A cutoff value for carcinomas of 1.14 x 10(-3) mm2/s yielded a sensitivity and specificity of 93.3% and 93.3%, respectively.


CONCLUSIONS
Our preliminary findings show that quantitative DWI may be able to differentiate the normal rectum from neoplastic involvement, in addition to distinguishing between inflammatory and neoplastic involvements. However, radiologists should be aware of possible overlaps that may lead to misdiagnoses when DWI is used alone.
Kilickesmez
Ozgur
O
Department of Radiology, School of Medicine, Yeditepe University, Istanbul, Turkey. okilickesmez@yahoo.com
Atilla
Serhan
S
Soylu
Aliye
A
Tasdelen
Neslihan
N
Bayramoglu
Sibel
S
Cimilli
Tan
T
Gurmen
Nevzat
N
D000230:Adenocarcinoma / Q000473:pathology*; D016022:Case-Control Studies; D012809:Colon, Sigmoid / Q000473:pathology; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015212:Inflammatory Bowel Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012007:Rectum / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media; D019786:Gadolinium DTPA