Male 56 years old Reason: cancer surveillance - rectal carcinoma. s/p transanal endoscopic microsurgical History: rectal carcinoma Overall image quality: Good, but patient refused intravenous contrast, which limits evaluation.PELVIS:PROSTATE/SEMINAL VESICLES: Diffuse low T2 signal in the peripheral zone of the prostate is nonspecific, please correlate with PSA levels.BLADDER: No significant abnormality noted. LYMPH NODES: Lymph nodes in the perirectal space, within the mesorectal fascia: NoneLymph nodes outside the mesorectal fascia: NoneBOWEL, MESENTERY: Rectal Tumor: There is asymmetric thickening of rectosigmoid colon, this may be in part due to residual fecal material or underdistention, but given the lack of contrast cannot be characterized further. There is no abnormal diffusion signal at this region or mesorectal lymph node.Size: 2.7 x 1.8 x 3.5 cm (image 601/series 38)Tumor appearance on T2-weighted images: Predominantly solid lesion with intermediate signal intensityTumor location: Rectosigmoid region(For lower rectal tumors):Distance of the lower edge of the tumor to the anal verge (lower edge of the anal canal): 4 cmDistance of the lower edge of the tumor to the pelvic floor (relationship of the tumor to the anal sphincter complex): 9 cmCircumference of the rectum involved: 50%Relationship and proximity of the tumor to adjacent structures (prostate, seminal vesicles): Not invaded.MRI T-stage: T2 - Tumor invades submucosal and/or tumor invades muscularis propriaNo extension outside the serosa and no encroachment on the mesorectal fascia.BONES/SOFT TISSUES: No significant abnormality noted.OTHER: Focal fat herniation through the right levator muscle.
This is a limited study due to lack of IV contrast as patient refused further imaging.1.Asymmetric thickening of the rectosigmoid colon could represent neoplasm as characterized above, but given lack of contrast please correlate with direct visualization.2.Nonspecific diffuse T2 hypointensity in the peripheral zone of the prostate, please correlate with PSA levels.