Chen Nan MD, Presenter: Nothing to Disclose

Kuncheng Li MD, Abstract Co-Author: Nothing to Disclose

The total mesorectal excision (TME), which the surgical removal of rectal tumor and the surrounding mesorectum along the mesorectal fascia (that is circumferential resection margin, CRM), has become the standard surgical method of rectal cancer which originated from the section below the pelvic peritoneum reflection. Therefore, to preoperatively comprehensive evaluate the state of mesorectal fascia is very important an impact on the decision of potential for TME surgical removal as well as whether neoadjuvant therapy should be administered. So, our Purpose is to evaluate the CT manifestations of the mesorectal fascia invasion of rectal carcinoma.

Seventy-eight patients with rectal carcinoma which originated from the section below the pelvic peritoneum reflection underwent preoperative CT examinations and the operations were performed with TME method in 72 resectable tumor. Compared the CT characteristics of mesorectal fascia invasion of rectal carcinoma with the pathologic findings.

In 78 cases, 51 cases rectal carcinoma had penetrated through the rectal wall present patching-like, lining or mass shadows distributed within the perirectal fat tissue on CT. Among them, none of rectal fascia was thicken on CT in 27 cases. In these cases, no tumor cells infiltrating was found in the CRM proved by pathology. The thickenings of the rectal fascia present even or irregularly thickened was found in 24 cases on CT. In these cases, the invasion outside of rectal fascia into the pararectal space on CT and the CRM involvement proved by pathology was 11 cases and 13 cases, respectively. The e values was 0.818 and the p<0.001, CT is excellent agreement with the pathologic on the invasion outside of rectal fascia. The tumor had occupied the pararectal space invading the surrounding organs couldnt separate from the rectal fascia and unresectable in 6 cases.

CT is valuable in identifying tumor invasion mesorectal fascia. The state of mesorectal fascia on CT is excellent agreement with the pathologic findings of CRM.

it’s very import for preoperative determination of resectability, surgical approach and prognosis of rectal carcinoma.

Nan, C, Li, K, CT Manifestations of the Mesorectal Fascia Invasion of Rectal Carcinoma.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13018249.html