A rectal submucosal tumour is defined as a mass-like protrusion in the rectum covered by normal mucosa. It comprises a variety of benign and malignant tumours that originate from the rectal wall or outside the rectum. Full characterisation by endoscopy or endoscopic biopsy is often difficult due to its deep location. Magnetic resonance imaging (MRI) can provide information about the origin, internal composition, and local extent of the tumour. Radiologists should be familiar with the types and MRI features of rectal submucosal tumours to facilitate accurate diagnosis and guide management.
Accurate staging by high-resolution magnetic resonance imaging (MRI) is pivotal to the multidisciplinary management of rectal cancer. Aside from tumour and lymph node staging, high-resolution MRI can identify other imaging prognosticators to stratify patients to different prognostic groups for different treatment. These imaging prognosticators include circumferential resection margin, extramural venous invasion, extramural depth of tumour extension, vascular / tumour deposits, mucinous primary tumour, and relationship to the intersphincteric plane (in low-rectal tumours). This review describes the imaging features and prognostic impact of these MRI-detected biomarkers.
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