MRI features of rectal adenocarcinomas in 30 cases
Objective To observe the MRI features of rectal adenocarcinoma(RAC),and to explore its plain and enhanced scan features.Methods The clinical data of 30 patients with primary RAC who underwent laparoscopic radical resection in the Second Affiliated Hospital of Air Force Military Medical University from January to December 2022 were retrospectively analyzed.All patients underwent pelvic MRI plain scan and enhanced scan before surgery to record the location of RAC,vertical diameter of RAC,distance from the lower edge of RAC to the anal verge,involvement of anal canal,extramural vascular invasion score,etc.TNM staging was performed,and MRI features of RAC were analyzed.Results(1)Among these 30 patients,RAC was located at the low segment of rectum in 10 patients,at the middle segment in 16 patients,at the upper segment in 11 patients,and at middle upper segment or middle low segment in 7 patients.The vertical diameter of RAC ranged from 2.0 to 10.8(6.4±4.4)cm.(2)There were 9 cases at stage T2,19 at stage T3,and 2 at T4;6 cases at stage N1 and 24 at stage N2;27 cases at stage M0 and 3 at stage M1.(3)The distance from the lower edge of RAC to the anal verge was 1.1 to 13.7(7.4±6.3)cm.RAC involved the anal canal in 3 cases and involved no anal canal in 27 cases.Extramural vascular invasion score was 0 in 3 cases,1 in 4 cases,2 in 10 cases,3 in 7 cases and 4 in 6 cases.(4)The main MRI features of RAC were equal or slightly lower signal shadow on axial T1WI.Most of RAC invaded the surrounding adipose space,and slightly higher or high lamellar signal shadows were seen in the adipose space on axial short tau inversion recovery.The tumors showed an equal or slightly lower signal shadow on fat suppressor T1WI,and significantly uneven enhancement on the enhanced sequences.Conclusion RAC is usually featured by irregular narrowing of the intestinal cavity,involving a long rectal segment,prone to regional lymph node metastasis and extramural vascular invasion,mostly infiltrative growth pattern along the surrounding adipose space,and significant uneven enhancement in MRI.
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