Diagnostic Ultrasound - Abdomen and Pelvis

Large Bowel Malignancy
(Left) Hepatic flexure tumor is
shown. There is
circumferential hypoechoic
thickening and loss of the
normal mural stratification
. There are extramural
nodular tongues of tumor
extending into the pericolonic
fat medially ſt, and also
extending to involve the
peritoneum laterally ,
indicating T4 disease. (Right)
Hepatic flexure tumor on CECT
from the same patient shows
circumferential thickening to
the colon ſt, with
involvement and thickening to
the right parietal peritoneum
, in keeping with T4 disease.
Diagnoses: Bowel
(Left) US in a patient with
polypoidal carcinoma shows a
hypoechoic lesion within the
lumen of the transverse colon
ſt. The echogenic submucosa
and the hypoechoic
muscularis propria are
intact, indicating T1 disease.
Note the inferior edge of the
liver . (Right) Endoluminal
colonoscopic image depicting
the polypoidal lesion ſt in the
same patient represents a
polypoidal carcinoma.
(Courtesy V. Rudralingam,
MD).
(Left) Transrectal ultrasound
shows a large polypoidal
tumor ſt with extramural
tumor st breaching the outer
hypoechoic muscularis propria
layer , indicating a T3
tumor. Note the seminal
vesicles . (Right) T2-
weighted MR from the same
patient shows the
intermediate intensity
polypoidal tumor ſt with
extramural tongue of tissue
st extending beyond the lowsignal
muscularis propria
into the mesorectal fat,
representing T3 tumor. Note
the seminal vesicles .
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