Post-treatment fistulas in patients with rectal cancer: MRI with rectal superparamagnetic contrast agent.
MRI is the standard modality in the pre- and post-treatment evaluation of patients with rectal cancer, particularly in those cases with locally advanced disease. We routinely employ a superparamagnetic iron oxide (SPIO) contrast enema to distend the rectal lumen and achieve maximal tumor-to-lumen contrast gradient. This practice also allowed the identification of a fistula in 24% of patients treated for rectal cancer. Contrast agent-related low intensity signal could be seen filling the tract and eventually opacifying surrounding organs (i.e., vagina) or collections (i.e., presacral abscess). Fistula formation after radiochemotherapy and surgery for rectal cancer is not uncommon. MRI with dark lumen contrast enema allows an effective demonstration of this complication in a high number of patients.
Petrillo
Antonella
A
Department of Radiology, INT Pascale, via crispi 92, 80121, Naples, Italy.
Catalano
Orlando
O
Delrio
Paolo
P
Avallone
Antonio
A
Guida
Cesare
C
Filice
Salvatore
S
Siani
Alfredo
A
D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D052203:Ferrosoferric Oxide; D005402:Fistula / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007501:Iron; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D010388:Pelvis / Q000473:pathology; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000628:therapy*; D012833:Siloxanes
D003287:Contrast Media; D058185:Magnetite Nanoparticles; D010087:Oxides; D012833:Siloxanes; C088769:ferumoxsil; D007501:Iron; D052203:Ferrosoferric Oxide