Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion

Figure 3 Images obtained in an 86 year-old woman with middle rectal cancer. A: Orthogonal axial high-resolution T2-weighted MR image shows the tumor as a thickening (arrow) along the posterior aspect of the rectum, infiltrating through the muscularis propria (the band of proper muscle layer (*) is destroyed) into the mesorectal fat. The mesorectal fascia is seen as a thin hypointense line (arrowhead) surrounding the mesorectal fat; B: Multiplanar reconstruction (MPR) para-axial contrast enhanced computed tomography image of the same patient shows the tumour as an irregular mural thickening of the posterior rectal wall with spiculations extending into the peri-rectal fat. The mesorectal fascia is well defined and not involved (arrowhead); C: DWIBS image (b-value 1000), the tumor (arrow) is clearly recognizable as high signal in comparison with the lower signal intensity of the normal rectal wall.