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14 MRI of primary rectal cancer v2

MRI of primary rectal cancer

PhD. MD Hoang Dinh Au

Background (1)

High-resolution T2-weighted imaging is the key sequence in the magnetic
resonance (MR) imaging evaluation of primary rectal cancer. This sequence
generally consists of thin-section (3-mm) axial images obtained orthogonal to
the tumor plane, with an in-plane resolution of 0.5–0.8 mm.

Normal anatomy MRI

Imaging plan: incorrect angulation

Imaging plan

Background (2)

Differentiate T2 from T3 tumors
Deep of tumor invasion outside the muscularis propria
Relationship of tumor to the mesorectal fascia, anal sphincter, pelvic sidewall
Pelvic nodal involvement

1) Assessement of the primary tumor

T2 tumor

T3 tumor

T3a: <5mm
T3b: 5-10mm
T3c: >10mm

T3 tumor



T4 tumor

Rectal cancer division

Low <5cm, Midle: 5-10cm, High: >10cm.
Distance > 1mm from CRM or MRF

Cliquez pour modifier les styles du texte du masque
Deuxième niveau
Troisième niveau
Quatrième niveau
Cinquième niveau

LAR: Low Anterior Resection, ISR: InterSphincter Resection
APR: AbdominoPeritoneal Resection
EAS: External Sphincter Complex, LA: Levator Ani, IAS: Internal Anal Sphincter. PR: Puborectalis, ISP: Intersphincter

2) Deep of tumor invasion outside the muscularis propria

Invasion of T3 tumors

3) Relationship of tumor to other anatomic structures

Mesorectal fascia

Peritoneal reflection

Anal sphincter

Pelvic sidewall

Vascular invasion

Lymph nodes involvement

Mesorectal lymph node involvement

Pelvic sidewall lymph node involvement

Problem of angulation

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