الفهرس 
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Abstract
majority of CRC develop slowly from adenomatous
polyps or adenomas. Recently, several studies suggested that CRC is a
result of many factors, which are not only inherited but also acquired over
the life course of the individual.
Colorectal cancer is the third most common cancer in men and the
Rectal tumor staging is commonly performed using various modalities
such as computed tomography (CT) scan, magnetic resonance imaging
(MRI) scan and endoscopic ultrasound (EUS). MRI currently is the most
advanced staging modality able to depict the fascia and its relation to the
tumor margins precisely. To identify and stage rectal cancer with MRI,
high resolution T2 weighted image with thin sections is the primary
approach used to differentiate between the tumor, mucosal, submucosal
layers, muscular layers, perirectal fat and mesorectal fascia.
Rectal MRI may add value in patient care in various scenarios. In
primary staging (preoperative setting), MRI can assist in: selecting
patients with LARC who are suitable for treatment with neoadjuvant
CRT, guiding surgeons in surgical planning and identifying poor
prognostic factors, including extramural vascular invasion (EMVI),
mucin content, and involvement of the mesorectal fascia (MRF).
In the restaging setting (after treatment with neoadjuvant CRT),
rectal MRI can help in: evaluating tumor regression, tailoring surgical
planning, detecting a complete clinical response, along with a review of
the results of digital rectal examinations and endoscopic procedures and
monitoring patients undergoing the non-surgical treatment approach. So,
Summary
88
the aim of this study was to study the value of MRI in diagnosis and
staging of rectal cancer.
To elucidate our aim, this study was to A cross section study was
conducted in the period from October 2020 till April 2021 at Radio
Diagnosis Department, Menoufia University Hospitals. The study
involved 30 patients with suspected cancer rectum (13 male and 17
females). They were referred from clinical oncology and general surgery
departments. The age of patients ranged from 39 to 84 years.
All patients were subjected to the following: Complete history taking
included personal, past and family history. Analysis of the clinical
presentation with emphasis on (bleeding per rectum, blood in stool,
constipation, change in bowl habits, unexplained weight loss, and deep
pelvic pain). Laboratory data or previous results of colonoscopy or
other imaging studies whenever possible. MRI of the pelvis with
contrast: The MRI examination was performed using a 1.5-Testa unit.
Patients were imaged in the supine position head first using an eightchannel
phased-array body coil.
The results of the study could be summarized as follow:
The most commonly affected group was (65- <75) 10 patient
(33.33%) and the females were more commonly affected than males
(56.67% to 43.33% respectively).
The main clinical presentation of the studied patients was bleeding
per rectum 7 (23.33%), followed by blood in stool 6 (20%) and
constipation 5 (16.67%). However, 4 patients (13.33%) were
presented by each of change in bowl habits, unexplained weight loss
and deep pelvic pain.
Middle rectal tumor (26.67%) was least detected than upper rectum
(33.33%) and lower rectum that was in detection (40%). The most
Summary
89
male patients had bleeding per rectum (46.2%). While, the most
female patients had constipation (35.3%). The most male and female
patients were non mucinous (69.23% and 70.6% respectively). The
most male patients had lower rectum (69.23%). While, the most
female patients had upper rectum (52.94%). Male patients who had
circumferetial muralthicle ening and polypoid mass were equal
(53.84%). While, there were no male patients having exophytic mass.
On the other hand, the most female patients had circumferetial
muralthicle ening (58.82%).
The most male patients were staged as T3 (38.4%). While, the female
patients who were staged as T1 were equal with the other who were
staged as T2 (30.8%) and The female patients who were staged as T3
were equal with the other who were staged as T4 (35.3%). The most
male and female patients were staged as N0. Whereas, male patients
were (69.23%) and female patients were (47.05%). The male patients
who were facilitated were other who were (46.2%) and restricted
(53.84%). While, all female patients were restricted (100%).The most
male patients were positive (69.23%). While, the most female patients
were negative (70.6%).