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European Radiology

, Volume 15, Issue 8, pp 1650–1657 | Cite as

Distribution of mesorectal lymph nodes in rectal cancer: in vivo MR imaging compared with histopathological examination. Initial observations

  • D. M. KohEmail author
  • G. Brown
  • L. Temple
  • H. Blake
  • A. Raja
  • P. Toomey
  • N. Bett
  • S. Farhat
  • A. R. Norman
  • I. Daniels
  • J. E. Husband
Gastrointestinal

Abstract

The aim of this work was to determine the distribution of mesorectal lymph nodes using T2-weighted magnetic resonance (MR) imaging compared with histopathological findings in patients with rectal carcinoma. Sixteen patients with rectal carcinoma undergoing primary surgery without pre-operative neoadjuvant treatment were evaluated using 3-mm axial T2-weighted MR imaging. The position of each visible mesorectal node on imaging was localised by measuring its minimum distance from the mesorectal fascia (dm), its minimum distance from the rectal wall (dr) and its distance from the distal tumour margin (dv). Independent assessment of dm, dr and dv was made at histopathological examination. Eighty-five mesorectal nodes on in vivo MR imaging were matched to histopathological findings. On imaging, 67/85 mesorectal nodes were found at the level of the tumour and 84/85 were identified at or within 5 cm proximal to the tumour. Only one out of 85 nodes was seen below the inferior tumour margin. The mean difference of dm and dr obtained on in vivo MR imaging and histopathological examination was 0.7 mm (95% confidence interval, CI, −0.12 to 1.42 mm) and −1.1 mm (95% CI −2.29 to 0.14 mm), respectively. Almost all mesorectal nodes visible on MR imaging were found at the level of tumour or within 5 cm proximal to the tumour. This has implications for the planning of MR imaging and the level of mesorectal transection at surgery.

Keywords

Rectum Cancer Magnetic resonance Lymph node Histopathology 

Notes

Acknowledgements

The authors would like to acknowledge Sheila Woodward for her help and assistance. This study was supported by a grant from the Royal College of Radiologists, UK.

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • D. M. Koh
    • 1
    Email author
  • G. Brown
    • 1
  • L. Temple
    • 1
  • H. Blake
    • 1
  • A. Raja
    • 1
  • P. Toomey
    • 1
  • N. Bett
    • 1
  • S. Farhat
    • 1
  • A. R. Norman
    • 1
  • I. Daniels
    • 1
  • J. E. Husband
    • 1
  1. 1.Academic Department of Radiology, Cancer Research UK Magnetic Resonance Group, Institute of Cancer ResearchRoyal Marsden HospitalSuttonUK

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