Magnetic resonance imaging and endorectal ultrasound for diagnosis of rectal lesions

European Journal of Medical Research

Justyna Szumilo¹  Iwonna Zelazowska-Cieslinska³  Marek Caban³  Agnieszka Mocarska³  Robert Klepacz¹  Malgorzata Kolodziejczak²  Elzbieta Staroslawska³  Iwona Sudol-Szopinska⁴  Franciszek Burdan⁵ 

[1] Department of Clinical Pathomorphology, Medical University of Lublin, 1 Ceramiczna Str., Lublin, 20-059, Poland;Department of Proctology, Hospital at Solec, 93 Solec Str., Warsaw, 00-382, Poland;St. John’s Cancer Centre, 7 Jaczewskiego Str., Lublin, 20-090, Poland;Department of Diagnostic Imaging, Second Faculty of Medicine, Medical University of Warsaw, 8 Kondratowicza Str., Warsaw, 03-242, Poland;Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego Str., Lublin, 20-090, Poland

关键词: Anal cancer;    Rectal cancer;    Perianal fistula;    Magnetic resonance;    Endorectal ultrasonography;   

Others  :  1103392
DOI  :  10.1186/s40001-014-0078-0

 received in 2014-08-07, accepted in 2014-12-16,  发布年份 2015

【 摘 要 】

Endorectal ultrasonography (ERUS) and magnetic resonance imaging (MRI) allow exploring the morphology of the rectum in detail. Use of such data, especially assessment of the rectal wall, is an important tool for ascertaining the perianal fistula localization as well as stage of the cancer and planning it appropriate treatment, as stage T3 tumors are usually treated with neoadjuvant therapy, whereas T2 tumors are initially managed surgically. The only advantage of ERUS over MRI is the possibility of assessing T1 tumors that could be treated by transanal endoscopic microsurgery. However, MRI is better for visualizing most radiological prognostic features in rectal or anal cancer such as a circumferential resection margin less than 1 mm, T stage at T1-T2 or T3 tumors with extramural extension less than 5 mm, absence of extramural vascular invasion, N stage at N0/N1, and tumors located in the middle or upper third of the rectum. It can also evaluate the intersphincteric space or levator ani muscle involvement. Increased signal on diffusion weighted imaging (DWI) and low apparent diffusion coefficient (ADC) values as well as an irregular contour and heterogeneous internal signal intensity seem to predict the involvement of pelvic lymphatic nodes better than their size alone. Computed tomography as well as other examination techniques, including digital rectal examination, contrast edema, recto- and colonoscopy, are less useful in staging of rectal cancer but still are very important screening tools.

【 授权许可】

   
2015 Burdan et al.; licensee BioMed Central.

【 图 表 】

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