Ung thư trực tràng - Đánh giá lại sau điều trị (Restaging)

The previously seen irregular enhancing circumferential mass involving the mid-to-upper rectum is smaller (4.5 cm in length) with a maximum single wall thickness of 0.9cm at 1-2 o’clock (previously 1.3cm).  It demonstrates T2W hypointensity with no areas of restricted diffusion. Interruption of the normal hypointense muscularis propria as noted previously at 10 o’clock region, as well as 4-5 o’clock region at the mid rectal region. 

There is now an increasing circumferential desmoplastic reaction surrounding the rectum with involvement/retraction of the anterior peritoneal reflection at the midline. However, a thin fat plane demarcation is still demonstrable with the urinary bladder. No irregularity/ thickening of the urinary bladder wall. Clear demarcation between the lesion and the seminal vesicles and prostate gland. Normal signal intensity of the seminal vesicles. 

The inferior mesorectal fascia appears preserved. Inferiorly, the levator ani, external and internal sphincters are preserved. Suspicious thickened vessel with heterogeneous signal intensity seen posterior to the mid-upper rectum (5-6 o’clock region), may represent extramural vascular invasion (EMVI). Several subcentimeter regional lymph nodes with enhancement, largest at presacral region (total number at least 6 nodes). Some of these nodes are located in close proximity to the adjacent mesorectal fascia. 

No abnormal marrow signal intensity in the visualized bones.