Preoperative staging and recurrence of rectal tumors. Comparison of transrectal ultrasonography and magnetic resonance [Stadiazione preoperatoria e recidive dei tumori del retto. Confronto tra ecotomografia transrettale e Risonanza Magnetica.]

The accuracy of transrectal US (TRUS) and of MRI was evaluated in the preoperative staging and in local recurrences of rectal cancers. Fifty-four patients were examined: 45, with known rectal cancer, for preoperative staging, and 9 for the evaluation of local recurrences. Nineteen patients were examined with MRI in basal conditions, 21 after rectal air enema and 5 after paramagnetic contrast enema (Gd-DTPA). The following parameters were evaluated for preoperative staging: wall infiltration, invasion of perirectal fat and adjacent structures, lymph node involvement. Morphologic and signal intensity (on MRI) changes were evaluated for the diagnosis of local recurrences. TRUS provided 2 false positives. In the same patients, basal MRI results were poor, owing to difficult demonstration of the different wall layers, while in the patients studied after air enema, the lesion was hyperintense. In 20 patients with a fat-infiltrating tumor, TRUS provided 3 false negatives and 2 false positives; basal MRI yielded poor results, while air enema and paramagnetic contrast enema clearly demonstrated all fat-infiltrating lesions, with only one false positive.