Abstract • Nineteen patients with middle and lower rectal carcinomas were operated on, with abdominoperineal resection in 10 patients, lower anterior resection with coloanal anastomosis in 6 patients, and colorectal anastomosis in 3 patients. The distance of the lower margin of the tumor to insertion of the levator ani on the rectal wall was correctly evaluated by computed tomography in 12(63%) of 19 patients and by magnetic resonance imaging in 13 (68%) of 19 patients, while digital examination correctly assessed the distance in 15(79%) of 19 patients. Computed tomography and magnetic resonance imaging were unable to assess extension through the rectal wall. No significant difference was observed between computed tomography and magnetic resonance imaging in assessing extension to the perivesical fat, adjacent organs, pelvic side wall, or lymph nodes. According to the TNM classification, magnetic resonance imaging correctly staged 74% (14/19) of carcinomas, while computed tomography correctly staged 68% (13/19). (Arch Surg. 1990;125:385-388) References 1. Butch RJ, Stark DD, Wittenberg J, et al. Staging rectal cancer by MR and CT . AJR . 1986;146:1155-1160.Crossref 2. Hodgman CG, MacCarty RL, Wolff BG, et al. Preoperative staging of rectal carcinoma by computed tomography and 0.15T magnetic resonance imaging . Dis Colon Rectum . 1986;29:446-450.Crossref 3. Guinet C, Buy JN, Sézeur A, et al. Preoperative assessment of the extension of rectal carcinoma: correlation of MR, surgical, and histopathologic findings . J Comput Assist Tomogr . 1988;12:209-214.Crossref 4. Margulis AR, Thoeni RF. The present status of the radiologic examination of the colon . Radiology . 1988;167:1-5.Crossref 5. Siegel S, Castellan NJ. Nonparametric Statistics for the Behavioral Sciences . New York, NY: McGraw-Hill International Book Co; 1988. 6. Spiessl B, Hermaneck P, Scheibe O, Wagner G. TNM Atlas UICC . New York, NY: Springer-Verlag NY Inc; 1985:108-113. 7. Grabbe E, Lierse W, Winkler R. The perirectal fascia: morphology and use in staging of rectal carcinoma . Radiology . 1983;149:241-246.Crossref 8. Guillaumin E, Jeffrey RB, Shea WJ, Asling CW, Goldberg HI. Perirectal inflammatory disease: CT findings . Radiology . 1986;161:153-157.Crossref 9. Thoeni RF, Moss AA, Schnyder P, Margulis AR. Detection and staging of primary rectal and rectosigmoid cancer by computed tomography . Radiology . 1981;141:135-138.Crossref 10. van Waes PFGM, Koehler PR, Feldberg MAM. Management of rectal carcinoma: impact of computed tomography . AJR . 1983;140:1137-1142.Crossref 11. Adalsteinsson B, Glimelius B, Graffman S, Hemmingson Pählman L. Computed tomography in staging of rectal carcinoma . Acta Radiol . 1985;26:45-55. 12. Freeny PC, Marks WM, Tyan JA, Bolen JW. Colorectal carcinoma evaluation with CT: preoperative staging and detection of postoperative recurrence . Radiology . 1986;158:347-353.Crossref 13. Balthazar EJ, Megibow AJ, Hulnick D, Naidich DP. Carcinoma of the colon: detection and preoperative staging by CT . AJR . 1988;150:301-306.Crossref 14. Koehler PR, Feldberg MAM, van Waes PFGM. Preoperative staging of rectal cancer with computerized tomography . Cancer . 1984;54:512-516.Crossref 15. Beyer WH. Handbook of Tables for Probability and Statistics . Boca Raton, Fla: CRC Press Inc; 1981. 16. Doubleday LC, Bernardino ME. CT findings in the perirectal area following radiation therapy . J Comput Assist Tomogr . 1980;4:634-638.Crossref 17. Glazer GM, Gross BH, Quint LE, Francis IR, Bookstein FL, Orringer MB. Normal mediastinal lymph nodes: number and size according to American Thoracic Society mapping . AJR . 1985;144:261-265.Crossref
Archives of Surgery – American Medical Association
Published: Mar 1, 1990
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