Endoscopic Ultrasonography versus Submucosal Enhancing Strip as Contrast Material Enhanced MRI in Rectal Lesions

Abstract

Background: The incidence of rectal cancer has risen. In addition, about 60% of rectal cancer cases are in the advanced stages of  diagnosis. The goals of colorectal cancer (CRC) screening are early diagnosis of cancer in the preclinical state and increasing survival.

Objective: To evaluate endoscopic ultrasonography versus submucosal enhancing strip as contrast material enhanced MRI in colorectal  lesions.

Patients and Methods: Thirty-three patients with colorectal lesions who were admitted to Kobry Elkoba Military Hospital were  included, diagnosed by colonoscopy followed by histopathological examination. Submucosal enhanced stripe MRI and endoscopic  ultrasound were done for all patients.

Results: Nineteen patients who underwent either endoscopic submucosal dissection or surgical  intervention with T1 and T4 were confirmed by pathological examination. Submucosal enhancing stripe (SES) MRI accuracy in T staging was 89.47% while in N staging was 94.74%. EUS accuracy in T staging was 100% while in N staging was 94.74%. The difference in accuracy  in T staging was in T3 and T4 only because the main target of SES MRI is differentiating T1 from T2. In T1 and T2 no significant difference  was reported between SES MRI and EUS. Regarding lymph node infiltration no significant difference was reported.

Conclusion: SES MRI  and EUS are comparable imaging techniques for the local and lymph node staging of rectal cancer.