MRI Pelvis (staging)
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MR Rectal Cancer Staging
Multiplanar noncontrast small field of view MR imaging of the pelvis has been obtained. The anorectal rectal tumour extends between the lower rectum and the anal verge.The superior border lies below the peritoneal reflection. It measures 10.5 cm inn length, and extends from 9 to 2 o'clock (clockwise). The tumour has two components - lower rectal and lower anal. The impression is that the two components are contiguous by a thin stalk along the anal canal where tumour is based at the 12 o'clock position superiorly and at the 10 o clock position in the mid-lower anal canal.
Tumour invades the muscularis propria and extends 5 mm into the mesorectal fat at 10-1 o clock where it abuts Denonvillier's fascia. The colorectal resection margin (CRM) is at risk here. There is no evidence of prostate invasion however. In the anal canal there is evidence of sphincter involvement but no T4 disease is seen. There no convincing evidence of extramural venous invasion. The peritoneal reflection is not involved. There is one suspicious mesorectal lymph nodes. There are no bone mets evident. There is no extension into the presacral fat.
Conclusion: This is an advancedT3 N1 MX anorectal cancer CRM is at risk at 10 - 1 o clock where T3 disease abuts Denonvillier's fascia.