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Rectal cancer in inflammatory bowel diseases: MR imaging findings

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Abstract

Purpose

To retrospectively analyze the MR imaging features of rectal cancer in patients with inflammatory bowel diseases (IBD).

Materials and methods

The MR imaging examinations of 13 patients with IBD-related rectal cancer were retrospectively reviewed. MR imaging included T2-weighted, diffusion-weighted (DW), and gadolinium chelate-enhanced MR imaging. MR imaging findings were analyzed and compared with endoscopic and histopathological findings.

Results

Eight patients (8/13; 62%) had active IBD and five (5/13; 38%) had quiescent IBD on MR imaging. Two different tumor patterns were individualized including clearly visible soft-tissue mass (4/13; 31%) (Type 1 tumor) and marked circumferential rectal wall thickening (9/13; 69%) (Type 2 tumor). Twelve tumors (12/13; 92%) showed high signal intensity on T2-weighted MR images. All six tumors studied with DW-MR imaging (6/6; 100%) showed high signal on DW-MR imaging with restricted diffusion on apparent diffusion coefficient (ADC) map. On gadolinium chelate-enhanced MR imaging, heterogeneous enhancement was observed in one tumor (1/13; 8%), whereas 12 tumors (12/13; 92%) showed homogeneous enhancement. MR imaging showed pelvic fistula and intrapelvic abscess in association with four (4/13; 31%) and two tumors (2/13; 15%), respectively.

Conclusion

Our limited retrospective study demonstrates that rectal cancer in IBD patients can present as a circumferential wall thickening resembling inflammation and can occur in the absence of fistula or abscess. The use of T2-weighted and DW-MR imaging is recommended to improve rectal cancer detection in patients with long-standing IBD.

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Acknowledgements

All authors have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted.

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Authors and Affiliations

  1. Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010, Paris, France

    Matthias Barral, Mourad Boudiaf, Anthony Dohan & Philippe Soyer

  2. Department of Imaging, Hôpital Robert Debré, 11 Boulevard Pasteur, 51092, Reims Cedex, France

    Christine Hoeffel

  3. Université Paris-Diderot, Sorbonne Paris Cité, 10 Avenue de Verdun, 75010, Paris, France

    Anthony Dohan, Philippe Marteau & Philippe Soyer

  4. Department of Digestive Diseases, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010, Paris, France

    Philippe Marteau

  5. Department of Radiology, CHU Nancy-Brabois, Allée du Morvan, 54511, Nancy Cedex, France

    Valérie Laurent

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  1. Matthias Barral
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  2. Christine Hoeffel
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  3. Mourad Boudiaf
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  6. Valérie Laurent
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  7. Philippe Soyer
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Correspondence to Philippe Soyer.

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Barral, M., Hoeffel, C., Boudiaf, M. et al. Rectal cancer in inflammatory bowel diseases: MR imaging findings. Abdom Imaging 39, 443–451 (2014). https://doi.org/10.1007/s00261-014-0103-3

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  • DOI: https://doi.org/10.1007/s00261-014-0103-3

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