AIM: To determine the effect of rectal distension, used by some workers to facilitate staging, on mesorectal tissues. SUBJECTS AND METHODS: Ninety-seven consecutive rectal cancer staging MRI examinations were identified of which 76 were analysable: 48 studies were performed using rectal insufflation of 100 ml room air and 28 were performed without distension. Median age was 69 and 72 years, respectively. In each patient a single experienced observer measured the distance from the outer rectal wall to the inner margin of the mesorectal fascia at four locations (12, 3, 6 and 9 o'clock), excluding sites of tumour involvement, from the T1-weighted axial image at the level of the sacro-coccygeal junction. The two groups of measurements were compared using Mann-Whitney test statistic, and frequencies then categorized into <5 mm or > or =5 mm, and compared using Fisher's exact test. RESULTS: The median distance between the rectal wall and mesorectal fascia in the distended group was approximately half that found in the non-distended group, and significantly lower at the 3, 6 and 9 o'clock positions (p<0.001). 68/167 (41%) of measurements were 5mm or less, compared with 19/104 (18%) in the non-distended group (p<0.001). CONCLUSION: Rectal distension before MRI significantly reduces the distance between the rectal wall and mesorectal fascia. Although this is advocated to facilitate visualization of the primary tumour, it potentially affects the accuracy with which a clear circumferential resection margin can be predicted.
AIM: To determine the effect of rectal distension, used by some workers to facilitate staging, on mesorectal tissues. SUBJECTS AND METHODS: Ninety-seven consecutive rectal cancer staging MRI examinations were identified of which 76 were analysable: 48 studies were performed using rectal insufflation of 100 ml room air and 28 were performed without distension. Median age was 69 and 72 years, respectively. In each patient a single experienced observer measured the distance from the outer rectal wall to the inner margin of the mesorectal fascia at four locations (12, 3, 6 and 9 o'clock), excluding sites of tumour involvement, from the T1-weighted axial image at the level of the sacro-coccygeal junction. The two groups of measurements were compared using Mann-Whitney test statistic, and frequencies then categorized into <5 mm or > or =5 mm, and compared using Fisher's exact test. RESULTS: The median distance between the rectal wall and mesorectal fascia in the distended group was approximately half that found in the non-distended group, and significantly lower at the 3, 6 and 9 o'clock positions (p<0.001). 68/167 (41%) of measurements were 5mm or less, compared with 19/104 (18%) in the non-distended group (p<0.001). CONCLUSION: Rectal distension before MRI significantly reduces the distance between the rectal wall and mesorectal fascia. Although this is advocated to facilitate visualization of the primary tumour, it potentially affects the accuracy with which a clear circumferential resection margin can be predicted.
Authors: Doenja M J Lambregts; Miriam M van Heeswijk; Andrea Delli Pizzi; Saskia G C van Elderen; Luisa Andrade; Nicky H G M Peters; Peter A M Kint; Margreet Osinga-de Jong; Shandra Bipat; Rik Ooms; Max J Lahaye; Monique Maas; Geerard L Beets; Frans C H Bakers; Regina G H Beets-Tan Journal: Eur Radiol Date: 2017-04-13 Impact factor: 5.315
Authors: Regina G H Beets-Tan; Doenja M J Lambregts; Monique Maas; Shandra Bipat; Brunella Barbaro; Filipe Caseiro-Alves; Luís Curvo-Semedo; Helen M Fenlon; Marc J Gollub; Sofia Gourtsoyianni; Steve Halligan; Christine Hoeffel; Seung Ho Kim; Andrea Laghi; Andrea Maier; Søren R Rafaelsen; Jaap Stoker; Stuart A Taylor; Michael R Torkzad; Lennart Blomqvist Journal: Eur Radiol Date: 2013-06-07 Impact factor: 5.315
Authors: Monique Maas; Doenja M J Lambregts; Max J Lahaye; Geerard L Beets; Walter Backes; Roy F A Vliegen; Margreet Osinga-de Jong; Joachim E Wildberger; Regina G H Beets-Tan Journal: Abdom Imaging Date: 2012-06