Role of MRI with Diffusion Weighted Images in Evaluation of Rectal Carcinoma

A.F.Yousef 1, M.M.Refaat1, G.E.Saleh2 and I.S.Gouda3"


Traditionally, rectal cancer staging was done histopathologically, after surgery, to achieve a prognosis. However, with the implementation of adjuvant therapy, staging has become more relevant to the available therapeutic options. Preoperative staging is now crucial as the surgical techniques have evolved and neoadjuvant therapy has been implemented as an alternative in the treatment protocol. This advancement has also raised the issue of restaging before surgery in order to modify treatment strategy according to tumour response. : To assess the role of magnetic resonance with diffusion in diagnosis, staging of rectal carcinoma in relation to histopathological findings. This study was conducted upon 30 patients proved to be rectal carinoma by colonoscopy. Patient selection: 30 patients were included of both sexes (17 male & 13 females) with no age predilection (ranging between 27 years and 84 years). The rectal lesions located at the rectum in 27 of (13 located at upper 1/3 , 5 located at middle 1/3, 7located at lower 1/3 with 2 cases occupping the whole rectum) while the remaining 3 (2 located at the rectosigmoid region , the other one located at anorectal region). 77% of the patients of the studied groups presented with mural thickening and 20% presented with mural thickening with fungating endoluminal mass while 3% presented with mural thickening with exophytic mass. Our study results demonstrate that high-resolution MRI has pivotal role in accurate staging of rectal cancer and prediction of negative CRMs and involvement of the perirectal and pelvic LNs. Thus, we conclude MRI has a golden standard value in the establishment of the best treatment strategy.

Key words

Rectal, Cancer, Histopathological, Colonoscopy, Endoluminal, Magnetic Resonance.