Comparison of Transrectal Sonography and Double-Contrast MR Imaging When Staging Rectal Cancer
Michael H. Fuchsjäger1,
Andrea G. Maier1,
Wolfgang Schima1,
Eva Zebedin1,
Friedrich Herbst2,
Martina Mittlböck3,
Friedrich Wrba4 and
Gerhard L. Lechner1
1 Department of Radiology, University of Vienna, Währinger Gürtel
18-20, A-1090 Vienna, Austria.
2 Department of Surgery, University of Vienna, A-1090 Vienna, Austria.
3 Department of Medical Computer Sciences, University of Vienna, A-1090 Vienna,
Austria.
4 Department of Clinical Pathology, University of Vienna, A-1090 Vienna,
Austria.
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Fig. 1A. —62-year-old man with stage pT3 pN2 rectal carcinoma. Transrectal
sonogram of upper third of rectum shows hypoechogenic lesion
(arrowheads) between 10- and 2-o'clock positions. Tumor extension
cannot be seen because of bending of rectum caused by sacral flexure.
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Fig. 1B. —62-year-old man with stage pT3 pN2 rectal carcinoma. Transverse
T1-weighted spin-echo MR image after IV administration of gadolinium and
rectal administration of ferristene shows circular stenotic concentric
thickening of rectal wall with invasion (arrowheads) of perirectal
fat tissue between 8- and 2-o'clock positions. This lesion is located high in
rectum. Note malignant lymph node (arrow) in perirectal fat
tissue.
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Fig. 2. —55-year-old woman with stage pT3 pN1 rectal carcinoma. Axial
T1-weighted spin-echo MR image after IV administration of gadolinium and
rectal administration of ferristene shows large circular stenotic tumor
(arrowheads) in upper third of rectum. The high position of this
tumor made it inaccessible to transrectal sonography.
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Fig. 3A. —62-year-old man with stage pT4 pN2 pM1 rectal carcinoma. Axial
T1-weighted spin-echo MR image after IV administration of gadolinium and
rectal administration of ferristene shows circular stenotic tumor in middle
third of rectum and tumor infiltration of seminal vesicles
(arrows).
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Fig. 3B. —62-year-old man with stage pT4 pN2 pM1 rectal carcinoma. Transrectal
sonogram of lower third of rectum shows hypoechogenic lesion between 6- and
2-o'clock positions. Between 11- and 2-o'clock positions, tumor is confined to
muscularis propria; between 9- and 11-o'clock positions, tumor
(arrows) extends into perirectal fat. Probe could not be placed
properly because of stenosis caused by tumor. Infiltration of seminal vesicles
could not be visualized.
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Fig. 4. —46-year-old woman with stage pT1 pN0 rectal carcinoma. Transrectal
sonography shows hypoechoic lesion (arrowheads) confined to mucosa
and submucosa between 8- and 2-o'clock positions. This lesion was not detected
on double-contrast MR imaging (not shown).
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Fig. 5A. —64-year-old man with stage pT3 pN1 rectal carcinoma. Sagittal
T1-weighted spin-echo MR image after IV administration of gadolinium and
rectal administration of ferristene shows large tumor (arrowheads) in
middle and upper thirds of rectum.
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Fig. 5B. —64-year-old man with stage pT3 pN1 rectal carcinoma. Although lesion
is located high in rectum, transrectal sonogram shows it to be hypoechogenic,
between 1- and 4-o'clock positions, and infiltrating into perirectal fat
(arrowheads). Note malignant lymph node (arrows) in
perirectal fat tissue at 5-o'clock position.
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Copyright © 2003 by the American Roentgen Ray Society.
