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 . 677
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