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High-B-Value Diffusion-Weighted MRI in Colorectal Cancer

Tomoaki Ichikawa1, Sukru Mehmet Erturk2,3, Utarou Motosugi1, Hironobu Sou1, Hiroshi Iino4, Tsutomu Araki1 and Hideki Fujii4

1 Department of Radiology, Yamanashi University, Shimokato, Japan.
2 Brigham and Women's Hospital, Harvard Medical School, Radiology Suite, c/o One Brigham Circle, 1620 Tremont St., Boston, MA 02120.
3 Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
4 First Department of Surgery, University of Yamanashi, Shimokato, Japan.


Figure 1
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  		Fig. 1A —49-year-old man with adenocarcinoma of the ascending colon. Axial high-b-value diffusion-weighted (DW) MR image; localized, strong dark signal is visible at posterior wall of ascending colon (arrow).

 

Figure 2
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  		Fig. 1B —49-year-old man with adenocarcinoma of the ascending colon. Maximum-intensity-projection (MIP)-reconstructed coronal high-b-value DW-MR image. Lesion seen on Figure 1A is also shown on this image as "dark spot." Note that spinal cord and spleen also have strong black signals because of their small apparent diffusion coefficient (ADC) values (arrow).

 

Figure 3
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  		Fig. 1C —49-year-old man with adenocarcinoma of the ascending colon. Axial contrast-enhanced CT image; the lesion seen on Figures 1A and 1B is poorly visualized on this image (arrow).

 

Figure 4
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  		Fig. 1D —49-year-old man with adenocarcinoma of the ascending colon. Photograph of gross colectomy specimen; a 2-cm colon adenocarcinoma is presented at posterior wall of ascending colon; this location corresponds accurately to location determined on the high-b-value DW-MR images.

 

Figure 5
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  		Fig. 2 —44-year-old man with rectal adenocarcinoma (arrow); maximum-intensity-projection (MIP)-reconstructed sagittal high-b-value diffusion-weighted MR image.

 

Figure 6
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  		Fig. 3 —54-year-old man with rectal adenocarcinoma (arrows); maximum-intensity-projection (MIP)-reconstructed coronal high-b-value diffusion-weighted MR image; two metastatic lymph nodes are also visualized (arrowheads).

 

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