ABSTRACT
RATIONALE AND OBJECTIVES: To retrospectively assess the value of spectral presaturation by inversion-recovery (SPIR) magnetic resonance (MR) imaging sequence after gadolinium injection to differentiate fibrotic scar tissue and tumoral infiltration within the mesorectal fat in patients with rectal carcinoma undergoing MR restaging after neoadjuvant chemo- and radiation therapy (CRT). MATERIALS AND METHODS: Forty-three consecutive patients (mean age, 65.8 years; range, 46-85 years; male:female, 29:14) with locally advanced rectal carcinoma underwent CRT followed by surgery. MR imaging was performed before and after completion of CRT by using T2-weighted turbo spin-echo and T1-weighted SPIR sequences before and after gadolinium injection, and MR images were assessed by two radiologists in consensus. Logistic regression was conducted to test the significance of the MR image findings with histology. RESULTS: After CRT the disease was either limited to the rectal wall (n = 18 patients) or presented perirectal infiltration (n = 25) on histology. In 21 patients, mesorectal enhancing strands were observed. Reticular-shaped enhancing strands reaching the mesorectal fascia presented the highest correlation with tumor infiltration of the mesorectal fat (OR 130.33, 95% CI: 4.1-4220.29; logistic regression), whereas linear-shaped enhancing strands either reaching or not reaching the mesorectal fascia (OR 0.25 or 0.1, 95% CI: 0.024-2.6 or 0.01-1.07) revealed the lowest correlation. CONCLUSIONS: Reticular-shaped enhancing strands on SPIR MR imaging after gadolinium injection are associated with tumor infiltration of the mesorectal fat.
Subject(s)
Adipose Tissue/pathology , Chemoradiotherapy, Adjuvant , Cicatrix/pathology , Contrast Media/administration & dosage , Magnetic Resonance Imaging/methods , Neoplasm Invasiveness/pathology , Rectal Neoplasms/pathology , Rectal Neoplasms/therapy , Aged , Aged, 80 and over , Diagnosis, Differential , Fascia/pathology , Female , Fibrosis/pathology , Gadolinium , Gadolinium DTPA/administration & dosage , Heterocyclic Compounds/administration & dosage , Humans , Logistic Models , Male , Meglumine/administration & dosage , Middle Aged , Neoadjuvant Therapy , Neoplasm Staging , Organometallic Compounds/administration & dosage , Retrospective StudiesABSTRACT
BACKGROUND: Complete penile corporeal septation is a rare malformation in which the corpora cavernosa are completely isolated. We describe a new method to reach the diagnosis of this malformation using contrast enhanced US. METHODS: Two patients with complete penile corporeal septation underwent color Doppler and contrast enhanced US after bilateral cavernosal injection of 10 microg prostaglandin E1. Contrast enhanced US was performed using a contrast specific software (Contrast-Tuned imaging, EsaOte, Genoa, Italy) and a linear transducer designed to evaluate superficial structures. Microbubbles of SonoVue (Bracco, Milan, Italy) were injected in one corpus cavernosum. RESULTS: After cavernosal injection of microbubbles no adverse events were observed. Contrast enhanced US showed unilateral enhancement of the corpus cavernosum in which microbubbles were injected. Cavernosography confirmed unilateral corporeal opacification. CONCLUSION: Contrast enhanced US can be used effectively to diagnose complete penile corporeal septation.