Objective To explore the value of magnetic resonance diffusion kurtosis imaging (DKI) in the prediction of TN staging, differentiation and vascular invasion of rectal cancer.

Methods Forty-three patients with rectal cancer hospitalized in our hospital from 2017 to 2019 underwent routine MRI and DKI were selected, and DKI parameters were obtained by post-processing software. The lesions were resected and sent for pathological examination within one week.

Results With the increase of T staging, the MK value increased, and the difference of each parameter in each group of patients was statistically significant (P < 0.05), and the MD value was not significantly different. The lower the degree of pathological differentiation of rectal adenocarcinoma, the lower the MD value, and the higher the MK value. The overall differences in each group of patients were statistically significant (P < 0.05). The MK value of cases with vascular invasion was greater than that without vascular invasion, and the difference between the two was statistically significant (P < 0.05), with an AUC of 0.772, a sensitivity of 81.0%, and a specificity of 68.7%; there was no statistical difference in MD values. MK and MD values are statistically significant between the two groups of rectal cancer with lymph node metastasis (P < 0.05).

Conclusions MK value can assist in the diagnosis of rectal cancer T staging. MK and MD values can predict the degree of pathological differentiation of rectal cancer. The MK value can be used to predict whether there is vascular invasion around rectal cancer. MK and MD can assist in the diagnosis of lymph node metastasis in rectal cancer, and the combination of MK and MD has better diagnostic efficiency.