Double-contrast Magnetic Resonance Imaging in Preoperative Evaluation of Rectal Cancer: Use of Aqueous Jelly as Luminal Contrast Najla Fasih, FRCR, Vivek.

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Double-contrast Magnetic Resonance Imaging in Preoperative Evaluation of Rectal Cancer: Use of Aqueous Jelly as Luminal Contrast Najla Fasih, FRCR, Vivek Virmani, FRCR, Cynthia Walsh, FRCPC, Mattew McInnes, FRCPC, Blair MacDonald, FRCPC, Ania Kielar, FRCPC, Alampady Krishna Prasad Shanbhogue, MD Canadian Association of Radiologists Journal Volume 62, Issue 2, Pages 122-124 (May 2011) DOI: 10.1016/j.carj.2010.03.001 Copyright © 2011 Canadian Association of Radiologists Terms and Conditions

Figure 1 (A) Sagittal T2W images through the pelvis with rectal distension by using aqueous gel. The polypoidal tumour within the sigmoid is well seen as intermediate signal intensity lesion standing out against the rectal wall and lumen. (B) Oblique coronal T2W image demonstrates the lesion along the anterior rectal wall projecting into the lumen. Note the low signal intensity rectal wall is intact (arrows). (C) Sagittal post-gadolinium image demonstrates the lesion as high signal intensity against the low signal intensity bowel lumen. This was reported as a T1 lesion. Surgical pathology revealed a lack of invasion of muscularis layer and correlated well with imaging findings. Canadian Association of Radiologists Journal 2011 62, 122-124DOI: (10.1016/j.carj.2010.03.001) Copyright © 2011 Canadian Association of Radiologists Terms and Conditions

Figure 2 (A, B) Sagittal T2W images through the pelvis without and with rectal distension. The plaque-like tumour within the sigmoid is difficult to identify confidently in (A). It is accurately delineated in (B) as intermediate signal intensity lesion against the bright signal intensity imparted by luminal gel (arrows). (C) Coronal post-gadolinium image demonstrates the lesion against the low signal intensity bowel lumen. Note subtle irregularity and spiculation in the adjacent mesorectal fat. The imaging and surgical staging (T3) correlated well. Canadian Association of Radiologists Journal 2011 62, 122-124DOI: (10.1016/j.carj.2010.03.001) Copyright © 2011 Canadian Association of Radiologists Terms and Conditions