<?xml version="1.0"?>
<feed xmlns="http://www.w3.org/2005/Atom" xml:lang="en">
	<id>https://radlines.org/api.php?action=feedcontributions&amp;feedformat=atom&amp;user=Rhcastilhos</id>
	<title>radlines.org - User contributions [en]</title>
	<link rel="self" type="application/atom+xml" href="https://radlines.org/api.php?action=feedcontributions&amp;feedformat=atom&amp;user=Rhcastilhos"/>
	<link rel="alternate" type="text/html" href="https://radlines.org/Special:Contributions/Rhcastilhos"/>
	<updated>2026-07-25T22:07:59Z</updated>
	<subtitle>User contributions</subtitle>
	<generator>MediaWiki 1.33.0</generator>
	<entry>
		<id>https://radlines.org/index.php?title=File:Look_of_Radlines_on_the_day_of_its_creation.png&amp;diff=3971</id>
		<title>File:Look of Radlines on the day of its creation.png</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=File:Look_of_Radlines_on_the_day_of_its_creation.png&amp;diff=3971"/>
		<updated>2022-10-09T10:41:26Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Rhcastilhos uploaded a new version of File:Look of Radlines on the day of its creation.png&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;=={{int:filedesc}}==&lt;br /&gt;
{{Information&lt;br /&gt;
|description={{en|1=Radlines (then named Radviser) on April 10 2018, the day of its creation.}}&lt;br /&gt;
|date=2018-04-10&lt;br /&gt;
|source={{own}}&lt;br /&gt;
|author=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|permission=&lt;br /&gt;
|other versions=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
=={{int:license-header}}==&lt;br /&gt;
{{licensing|cc-by-4.0}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Radlines:About&amp;diff=3970</id>
		<title>Radlines:About</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Radlines:About&amp;diff=3970"/>
		<updated>2022-10-09T10:41:01Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* History */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;'''Radlines''' (at [https://www.radlines.org radlines.org]) is an online source for radiologists. It is an international, non-profit, open access, ad-free, MediaWiki-based online source that is editable by doctors, as well as selected administrators, while everyone is welcome to leave comments and suggestions at talk pages. The mission of Radlines is to gather the most relevant information in radiology and make it quickly accessible on the Internet free of charge, without ads, in perpetuity.&lt;br /&gt;
&lt;br /&gt;
==Participation==&lt;br /&gt;
Editors of articles must be doctors of medicine, or have formal expertise in radiology by other means. The [[Radlines:Discussion page|Discussion pages]], on the other hand, are editable by everyone, even without logging in, for comments and suggestions. Newcomers start participating by completing a form, at:&amp;lt;br&amp;gt;- '''[https://docs.google.com/forms/d/e/1FAIpQLSdqCj6TIIx8AuMiWthPWuohwxPoIVz7j0BUAIWQbrq-dT_Kqw/viewform Form: Application for Editor status (link)]'''&amp;lt;br&amp;gt;This will be reviewed by the board, and will generally be approved within a day during European daytime for radiologists or radiology trainees with a Doctor of Medicine degree. It does '''not''' require attaching any credentials such as a medical diploma. Yet, all edits made by the user are tracked in the MediaWiki software, and upon any irregular behavior, an investigation will be performed wherein the user may be requested to provide identification and credentials to the board. Failure to provide those items may result in that edits made by that user will be reverted. Thus, the activity of an editor is the main &amp;quot;job interview&amp;quot; in order to contribute. A possible adverse effect of this system is that the board may not know for certain whether an editor is actually a doctor or not, as long as she/he claims to be a doctor and edits like one. Yet, the quality of the content is thereby practically the same.&lt;br /&gt;
&lt;br /&gt;
An Editor may still use an anonymous username, but real names must be used in the author lists at the top of articles, see [[Radlines:Authorship]].&lt;br /&gt;
&lt;br /&gt;
Radlines may cooperate with other radiology-related organizations such as societies and hospitals, but is not directly affiliated with any such organization. Rather, it forms a community where individual doctors from all over the world can participate, regardless of memberships or affiliations with other organizations.&lt;br /&gt;
&lt;br /&gt;
==Content structure==&lt;br /&gt;
Articles in Radlines can be directly found by search engine, either by the internal search box at top, or external ones. In addition, each article subject should be connected with the main page through a series of pages, so that a radiologist can quickly find their way to it by appearance or other distinction of the condition. For example, [[Pneumonia]] on a chest X-ray should be found by the following sequence:&lt;br /&gt;
*[[Main]] --&amp;gt; [[Thorax]] --&amp;gt; [[Chest radiograph]] --&amp;gt; [[Consolidation on chest radiograph]] --&amp;gt; [[Pneumonia]]&lt;br /&gt;
&lt;br /&gt;
Radiologists should thereby be able to find an article about the type of image they have at hand through as little as 2 clicks, with no need to login, and no distracting ads.&lt;br /&gt;
&lt;br /&gt;
''Further information: [[Radlines:Editorial guidelines|Editorial guidelines]].''&lt;br /&gt;
&lt;br /&gt;
==What Radlines is NOT==&lt;br /&gt;
*Radlines is NOT a place to cut and paste '''copyrighted''' material, see [[Radlines:Copyright]]&lt;br /&gt;
*Radlines is NOT a place to '''promote''' own research, websites or organizations&lt;br /&gt;
*Radlines is not a '''mirror''' or a '''repository''' of images or media files: Uploads need to be relevant in the course of work for a radiologist, and must be properly integrated in its context, see [[Radlines:Editorial guidelines]]&lt;br /&gt;
*Radlines is NOT a place for editors who are '''protective''' of their prose: The project is collaborative, which means that other editors may edit, move and sometimes even remove the content&lt;br /&gt;
*Radlines is NOT a place to get personal medical '''advice''', see [[Radlines:Disclaimer]]&lt;br /&gt;
&lt;br /&gt;
==Differences from Radiopaedia==&lt;br /&gt;
Radlines is in most ways a non-profit and ad-free alternative to Radiopaedia, which is currently the most comprehensive wiki-based reference work in radiology. Radiopaedia is a &amp;quot;business&amp;quot; owned by Investling.com,&amp;lt;ref&amp;gt;{{cite web|url=http://investling.com/|title=Our Businesses|accessdate=2018-05-14|website=Investling.com}}&amp;lt;/ref&amp;gt; making profit by advertising and paid subscription. Radlines, on the other hand, is able to run on donations and volunteer time alone. &lt;br /&gt;
&lt;br /&gt;
Radlines also has less restrictive licensing of its content. Radiopedia by default uses the [https://creativecommons.org/licenses/by-nc-sa/3.0/ Creative Commons Attribution-NonCommercial-ShareAlike 3.0 license], which makes the material ineligible for integration into for example Wikimedia projects including Wikipedia. The &amp;quot;NonCommercial&amp;quot; part is contradictory to the business nature of the site. Content in Radlines, on the other hand, is by default licensed as [https://creativecommons.org/licenses/by/4.0/ Attribution 4.0 International license], which will allow the content to be used by a greater amount of scholarly websites around the world. Further information: [[Radlines:Copyright]]&lt;br /&gt;
&lt;br /&gt;
Also, Radiopaedia has limited ability for finding content by hierarchical browsing. Although it has a sorting of articles by &amp;quot;Section&amp;quot; or &amp;quot;System&amp;quot;, each of these categories contains hundreds to thousands of articles [https://radiopaedia.org/encyclopaedia/all/musculoskeletal?page=1 (Example)], with limited ability to conveniently find the most relevant content unless knowing the specific article title beforehand. Radlines, on the other hand, allows for browsing by anatomy, modality and visible findings, allowing readers to find the relevant information even without knowing the names for the radiologic findings at hand beforehand, nor which conditions are causing them. Further information: [[Radlines:Editorial_guidelines#Inter-article_structure|Editorial guidelines: Inter-article structure]]&lt;br /&gt;
&lt;br /&gt;
{|class=&amp;quot;wikitable&amp;quot;&lt;br /&gt;
!  !! Radiopaedia !! Radlines&lt;br /&gt;
|-&lt;br /&gt;
| Non-profit || No || Yes&lt;br /&gt;
|-&lt;br /&gt;
| Ads or paid subscription || Yes || No&lt;br /&gt;
|-&lt;br /&gt;
| Financial statement || Secret || Open&lt;br /&gt;
|-&lt;br /&gt;
| Default license || [https://creativecommons.org/licenses/by-nc-sa/3.0/ BY-NC-SA 3.0] || [https://creativecommons.org/licenses/by/4.0/ BY 4.0]&lt;br /&gt;
|}&lt;br /&gt;
&lt;br /&gt;
Radiopaedia started out in the same (but older versioned) WikiMedia system before switching to a separate platform, but MediaWiki has since evolved substantially, including support for scrollable stacks to display for example CT scans, and VisualEditor for editing without needing to learn wiki coding.&lt;br /&gt;
&lt;br /&gt;
==Differences from other radiology-related sources==&lt;br /&gt;
*[http://www.wikiradiography.net/ wikiradiography.net] is a free website for radiographers, sonographers and students of those professions, rather than radiologists.&lt;br /&gt;
*[https://en.wikipedia.org/ Wikipedia] is a general encyclopedia that does contain extensive information in radiology, but does not focus on presenting the information in an optimally concise way for radiologists in the course of their work. Otherwise, Radlines shares Wikipedia's feature of having most images uploaded to the shared database Wikimedia Commons [https://commons.wikimedia.org/wiki/Main_Page] (see also [[Radlines:Upload]]), making such images readily available for both Radlines and other online sources.&lt;br /&gt;
&lt;br /&gt;
==Organization==&lt;br /&gt;
Radlines is a member wiki of [[Prowikis]], which is a non-profit organization aimed at the creation and technical maintenance of profession-specific wikis.&lt;br /&gt;
&lt;br /&gt;
:''Further information: '''[[Prowikis]]'''''&lt;br /&gt;
&lt;br /&gt;
===Editors===&lt;br /&gt;
{{Editor summary&lt;br /&gt;
 | name                    =Mikael Häggström&lt;br /&gt;
 | qualifications          =[[Wikipedia:Doctor_of_Medicine#United_States_and_Canada|MD]]&lt;br /&gt;
 | position                =&lt;br /&gt;
 | image                   =Mikael Häggström 2017 (wide).jpg&lt;br /&gt;
 | link                    =https://en.wikipedia.org/wiki/User:Mikael_H%C3%A4ggstr%C3%B6m &lt;br /&gt;
 | professional_experience =Dr Mikael Häggström is from [[Wikipedia:Uddevalla|Uddevalla]], [[Wikipedia:Sweden|Sweden]], and graduated from [[Wikipedia:Uppsala University Faculty of Medicine|Uppsala University, Faculty of Medicine]] in 2013. He attended radiology residency at the radiology department at the [[Wikipedia:NU Hospital Group|NU Hospital Group]] between November 2016 and August 2019.&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
==History==&lt;br /&gt;
[[File:Look of Radlines on the day of its creation.png|thumb|250px|Radlines (then named Radviser) on the day of its creation on April 10, 2018.]]&lt;br /&gt;
Radlines was created April 10, 2018 by Mikael Häggström, during his radiology residency in Sweden. He is also frequent Wikipedia editor ([https://en.wikipedia.org/wiki/User:Mikael_H%C3%A4ggstr%C3%B6m Wikipedia presentation]), and also creator and editor-in-chief of [http://www.wikijmed.org/ WikiJournal of Medicine]. The project was started as &amp;quot;Radviser&amp;quot; on [https://meta.miraheze.org/wiki/Miraheze Miraheze], a free MediaWiki host, but moved to Civihosting servers on May 13. It was renamed to &amp;quot;Radlines&amp;quot; on May 23, 2018. &lt;br /&gt;
&lt;br /&gt;
{|class=&amp;quot;wikitable&amp;quot;&lt;br /&gt;
! Milestone !! Date !! Article&lt;br /&gt;
|-&lt;br /&gt;
| 100 pages || August 2, 2018 || [[Pelvic bones]] [https://radlines.org/index.php?title=Pelvic_bones&amp;amp;oldid=1431]&lt;br /&gt;
|-&lt;br /&gt;
| 200 pages || January 12, 2019 || [[Ultrasonography of hydronephrosis]] [https://radlines.org/index.php?title=Ultrasonography_of_hydronephrosis&amp;amp;oldid=2721]&lt;br /&gt;
|}&lt;br /&gt;
&lt;br /&gt;
==See also==&lt;br /&gt;
*[[Radlines:Contribute]]&lt;br /&gt;
*[[Radlines:Editorial guidelines]]&lt;br /&gt;
*[[Radlines:Copyright]]&lt;br /&gt;
&lt;br /&gt;
Social media pages:&lt;br /&gt;
*[https://www.facebook.com/radlines.org Facebook]&lt;br /&gt;
*[https://twitter.com/Radlines_org Twitter]&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=File:Look_of_Radlines_on_the_day_of_its_creation.png&amp;diff=3969</id>
		<title>File:Look of Radlines on the day of its creation.png</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=File:Look_of_Radlines_on_the_day_of_its_creation.png&amp;diff=3969"/>
		<updated>2022-10-05T09:44:54Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Rhcastilhos uploaded a new version of File:Look of Radlines on the day of its creation.png&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;=={{int:filedesc}}==&lt;br /&gt;
{{Information&lt;br /&gt;
|description={{en|1=Radlines (then named Radviser) on April 10 2018, the day of its creation.}}&lt;br /&gt;
|date=2018-04-10&lt;br /&gt;
|source={{own}}&lt;br /&gt;
|author=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|permission=&lt;br /&gt;
|other versions=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
=={{int:license-header}}==&lt;br /&gt;
{{licensing|cc-by-4.0}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Template:Steatosis_-_choice_of_modality&amp;diff=3968</id>
		<title>Template:Steatosis - choice of modality</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Template:Steatosis_-_choice_of_modality&amp;diff=3968"/>
		<updated>2021-09-10T16:16:17Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&amp;lt;noinclude&amp;gt;{{Top&lt;br /&gt;
|author1=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|author2=&lt;br /&gt;
|author3=&lt;br /&gt;
}}&amp;lt;/noinclude&amp;gt;&lt;br /&gt;
===Choice of modality===&lt;br /&gt;
*'''[[Ultrasonography of steatosis]]''' is a good method for screening. Quantification can be done, but it is not as accurate as MRI.&lt;br /&gt;
*'''[[MRI of liver steatosis]]''' is the most accurate method to quantify liver steatosis. &lt;br /&gt;
*'''[[CT of the liver]]''' should not be used to detect or stage liver steatosis. Steatosis on [[CT scan]] is displayed as a liver with attenuation lower than usual. CT has high sensitivity for moderate and severe steatosis, but lower for mild steatosis.&amp;lt;noinclude&amp;gt;&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&amp;lt;/noinclude&amp;gt;&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Radlines:About&amp;diff=3965</id>
		<title>Radlines:About</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Radlines:About&amp;diff=3965"/>
		<updated>2020-10-30T22:43:54Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Organization */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;'''Radlines''' (at [https://www.radlines.org radlines.org]) is an online source for radiologists. It is an international, non-profit, open access, ad-free, MediaWiki-based online source that is editable by doctors, as well as selected administrators, while everyone is welcome to leave comments and suggestions at talk pages. The mission of Radlines is to gather the most relevant information in radiology and make it quickly accessible on the Internet free of charge, without ads, in perpetuity.&lt;br /&gt;
&lt;br /&gt;
==Participation==&lt;br /&gt;
Editors of articles must be doctors of medicine, or have formal expertise in radiology by other means. The [[Radlines:Discussion page|Discussion pages]], on the other hand, are editable by everyone, even without logging in, for comments and suggestions. Newcomers start participating by completing a form, at:&amp;lt;br&amp;gt;- '''[https://docs.google.com/forms/d/e/1FAIpQLSdqCj6TIIx8AuMiWthPWuohwxPoIVz7j0BUAIWQbrq-dT_Kqw/viewform Form: Application for Editor status (link)]'''&amp;lt;br&amp;gt;This will be reviewed by the board, and will generally be approved within a day during European daytime for radiologists or radiology trainees with a Doctor of Medicine degree. It does '''not''' require attaching any credentials such as a medical diploma. Yet, all edits made by the user are tracked in the MediaWiki software, and upon any irregular behavior, an investigation will be performed wherein the user may be requested to provide identification and credentials to the board. Failure to provide those items may result in that edits made by that user will be reverted. Thus, the activity of an editor is the main &amp;quot;job interview&amp;quot; in order to contribute. A possible adverse effect of this system is that the board may not know for certain whether an editor is actually a doctor or not, as long as she/he claims to be a doctor and edits like one. Yet, the quality of the content is thereby practically the same.&lt;br /&gt;
&lt;br /&gt;
An Editor may still use an anonymous username, but real names must be used in the author lists at the top of articles, see [[Radlines:Authorship]].&lt;br /&gt;
&lt;br /&gt;
Radlines may cooperate with other radiology-related organizations such as societies and hospitals, but is not directly affiliated with any such organization. Rather, it forms a community where individual doctors from all over the world can participate, regardless of memberships or affiliations with other organizations.&lt;br /&gt;
&lt;br /&gt;
==Content structure==&lt;br /&gt;
Articles in Radlines can be directly found by search engine, either by the internal search box at top, or external ones. In addition, each article subject should be connected with the main page through a series of pages, so that a radiologist can quickly find their way to it by appearance or other distinction of the condition. For example, [[Pneumonia]] on a chest X-ray should be found by the following sequence:&lt;br /&gt;
*[[Main]] --&amp;gt; [[Thorax]] --&amp;gt; [[Chest radiograph]] --&amp;gt; [[Consolidation on chest radiograph]] --&amp;gt; [[Pneumonia]]&lt;br /&gt;
&lt;br /&gt;
Radiologists should thereby be able to find an article about the type of image they have at hand through as little as 2 clicks, with no need to login, and no distracting ads.&lt;br /&gt;
&lt;br /&gt;
''Further information: [[Radlines:Editorial guidelines|Editorial guidelines]].''&lt;br /&gt;
&lt;br /&gt;
==What Radlines is NOT==&lt;br /&gt;
*Radlines is NOT a place to cut and paste '''copyrighted''' material, see [[Radlines:Copyright]]&lt;br /&gt;
*Radlines is NOT a place to '''promote''' own research, websites or organizations&lt;br /&gt;
*Radlines is not a '''mirror''' or a '''repository''' of images or media files: Uploads need to be relevant in the course of work for a radiologist, and must be properly integrated in its context, see [[Radlines:Editorial guidelines]]&lt;br /&gt;
*Radlines is NOT a place for editors who are '''protective''' of their prose: The project is collaborative, which means that other editors may edit, move and sometimes even remove the content&lt;br /&gt;
*Radlines is NOT a place to get personal medical '''advice''', see [[Radlines:Disclaimer]]&lt;br /&gt;
&lt;br /&gt;
==Differences from Radiopaedia==&lt;br /&gt;
Radlines is in most ways a non-profit and ad-free alternative to Radiopaedia, which is currently the most comprehensive wiki-based reference work in radiology. Radiopaedia is a &amp;quot;business&amp;quot; owned by Investling.com,&amp;lt;ref&amp;gt;{{cite web|url=http://investling.com/|title=Our Businesses|accessdate=2018-05-14|website=Investling.com}}&amp;lt;/ref&amp;gt; making profit by advertising and paid subscription. Radlines, on the other hand, is able to run on donations and volunteer time alone. &lt;br /&gt;
&lt;br /&gt;
Radlines also has less restrictive licensing of its content. Radiopedia by default uses the [https://creativecommons.org/licenses/by-nc-sa/3.0/ Creative Commons Attribution-NonCommercial-ShareAlike 3.0 license], which makes the material ineligible for integration into for example Wikimedia projects including Wikipedia. The &amp;quot;NonCommercial&amp;quot; part is contradictory to the business nature of the site. Content in Radlines, on the other hand, is by default licensed as [https://creativecommons.org/licenses/by/4.0/ Attribution 4.0 International license], which will allow the content to be used by a greater amount of scholarly websites around the world. Further information: [[Radlines:Copyright]]&lt;br /&gt;
&lt;br /&gt;
Also, Radiopaedia has limited ability for finding content by hierarchical browsing. Although it has a sorting of articles by &amp;quot;Section&amp;quot; or &amp;quot;System&amp;quot;, each of these categories contains hundreds to thousands of articles [https://radiopaedia.org/encyclopaedia/all/musculoskeletal?page=1 (Example)], with limited ability to conveniently find the most relevant content unless knowing the specific article title beforehand. Radlines, on the other hand, allows for browsing by anatomy, modality and visible findings, allowing readers to find the relevant information even without knowing the names for the radiologic findings at hand beforehand, nor which conditions are causing them. Further information: [[Radlines:Editorial_guidelines#Inter-article_structure|Editorial guidelines: Inter-article structure]]&lt;br /&gt;
&lt;br /&gt;
{|class=&amp;quot;wikitable&amp;quot;&lt;br /&gt;
!  !! Radiopaedia !! Radlines&lt;br /&gt;
|-&lt;br /&gt;
| Non-profit || No || Yes&lt;br /&gt;
|-&lt;br /&gt;
| Ads or paid subscription || Yes || No&lt;br /&gt;
|-&lt;br /&gt;
| Financial statement || Secret || Open&lt;br /&gt;
|-&lt;br /&gt;
| Default license || [https://creativecommons.org/licenses/by-nc-sa/3.0/ BY-NC-SA 3.0] || [https://creativecommons.org/licenses/by/4.0/ BY 4.0]&lt;br /&gt;
|}&lt;br /&gt;
&lt;br /&gt;
Radiopaedia started out in the same (but older versioned) WikiMedia system before switching to a separate platform, but MediaWiki has since evolved substantially, including support for scrollable stacks to display for example CT scans, and VisualEditor for editing without needing to learn wiki coding.&lt;br /&gt;
&lt;br /&gt;
==Differences from other radiology-related sources==&lt;br /&gt;
*[http://www.wikiradiography.net/ wikiradiography.net] is a free website for radiographers, sonographers and students of those professions, rather than radiologists.&lt;br /&gt;
*[https://en.wikipedia.org/ Wikipedia] is a general encyclopedia that does contain extensive information in radiology, but does not focus on presenting the information in an optimally concise way for radiologists in the course of their work. Otherwise, Radlines shares Wikipedia's feature of having most images uploaded to the shared database Wikimedia Commons [https://commons.wikimedia.org/wiki/Main_Page] (see also [[Radlines:Upload]]), making such images readily available for both Radlines and other online sources.&lt;br /&gt;
&lt;br /&gt;
==Organization==&lt;br /&gt;
Radlines is a member wiki of [[Prowikis]], which is a non-profit organization aimed at the creation and technical maintenance of profession-specific wikis.&lt;br /&gt;
&lt;br /&gt;
:''Further information: '''[[Prowikis]]'''''&lt;br /&gt;
&lt;br /&gt;
===Editors===&lt;br /&gt;
{{Editor summary&lt;br /&gt;
 | name                    =Mikael Häggström&lt;br /&gt;
 | qualifications          =[[Wikipedia:Doctor_of_Medicine#United_States_and_Canada|MD]]&lt;br /&gt;
 | position                =&lt;br /&gt;
 | image                   =Mikael Häggström 2017 (wide).jpg&lt;br /&gt;
 | link                    =https://en.wikipedia.org/wiki/User:Mikael_H%C3%A4ggstr%C3%B6m &lt;br /&gt;
 | professional_experience =Dr Mikael Häggström is from [[Wikipedia:Uddevalla|Uddevalla]], [[Wikipedia:Sweden|Sweden]], and graduated from [[Wikipedia:Uppsala University Faculty of Medicine|Uppsala University, Faculty of Medicine]] in 2013. He attended radiology residency at the radiology department at the [[Wikipedia:NU Hospital Group|NU Hospital Group]] between November 2016 and August 2019.&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
==History==&lt;br /&gt;
[[File:Look of Radlines on the day of its creation.png|thumb|200px|Radlines (then named Radviser) on the day of its creation on April 10, 2018.]]&lt;br /&gt;
Radlines was created April 10, 2018 by Mikael Häggström, during his radiology residency in Sweden. He is also frequent Wikipedia editor ([https://en.wikipedia.org/wiki/User:Mikael_H%C3%A4ggstr%C3%B6m Wikipedia presentation]), and also creator and editor-in-chief of [http://www.wikijmed.org/ WikiJournal of Medicine]. The project was started as &amp;quot;Radviser&amp;quot; on [https://meta.miraheze.org/wiki/Miraheze Miraheze], a free MediaWiki host, but moved to Civihosting servers on May 13. It was renamed to &amp;quot;Radlines&amp;quot; on May 23, 2018. &lt;br /&gt;
&lt;br /&gt;
{|class=&amp;quot;wikitable&amp;quot;&lt;br /&gt;
! Milestone !! Date !! Article&lt;br /&gt;
|-&lt;br /&gt;
| 100 pages || August 2, 2018 || [[Pelvic bones]] [https://radlines.org/index.php?title=Pelvic_bones&amp;amp;oldid=1431]&lt;br /&gt;
|-&lt;br /&gt;
| 200 pages || January 12, 2019 || [[Ultrasonography of hydronephrosis]] [https://radlines.org/index.php?title=Ultrasonography_of_hydronephrosis&amp;amp;oldid=2721]&lt;br /&gt;
|}&lt;br /&gt;
&lt;br /&gt;
==See also==&lt;br /&gt;
*[[Radlines:Contribute]]&lt;br /&gt;
*[[Radlines:Editorial guidelines]]&lt;br /&gt;
*[[Radlines:Copyright]]&lt;br /&gt;
&lt;br /&gt;
Social media pages:&lt;br /&gt;
*[https://www.facebook.com/radlines.org Facebook]&lt;br /&gt;
*[https://twitter.com/Radlines_org Twitter]&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=CT_of_superior_mesenteric_artery_syndrome&amp;diff=3964</id>
		<title>CT of superior mesenteric artery syndrome</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=CT_of_superior_mesenteric_artery_syndrome&amp;diff=3964"/>
		<updated>2020-10-30T22:42:18Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
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|author1=[[User:Rhcastilhos|Rodrigo Castilhos]]&lt;br /&gt;
|author2=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|author3=&lt;br /&gt;
}}&lt;br /&gt;
Also known as Wilkie's syndrome, this condition occurs when the third part of the duodenum is compressed between the superior mesenteric artery and the aorta. Under normal conditions, there is retroperitoneal fat around the third part of the duodenum, which avoids compression by creating an aortomesenteric angle &amp;gt; 28º. &lt;br /&gt;
&lt;br /&gt;
==Planning==&lt;br /&gt;
{{Superior mesenteric artery syndrome - Indications and choice of modality}}&lt;br /&gt;
&lt;br /&gt;
==Evaluation==&lt;br /&gt;
Measure the following relations between the aorta and superior mesenteric artery:&lt;br /&gt;
* Aortomesenteric angle, where &amp;lt;25º indicates the condition&amp;lt;ref name=CardarelliLeite2016&amp;gt;Cardarelli Leite, Leandro et al. Abdominal vascular syndromes: characteristic imaging findings. Radiol Bras [online]. 2016, vol.49, n.4 [cited  2019-07-12], pp.257-263. Available from: &amp;lt;http://www.scielo.br/scielo.php?script=sci_arttext&amp;amp;pid=S0100-39842016000400011&amp;amp;lng=en&amp;amp;nrm=iso&amp;gt;. ISSN 0100-3984.  http://dx.doi.org/10.1590/0100-3984.2015.0136.&amp;lt;/ref&amp;gt;&lt;br /&gt;
* Aortomesenteric distance, where a distance &amp;lt;8 mm indicates the condition&amp;lt;ref name=CardarelliLeite2016/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
Also exclude:&lt;br /&gt;
*Compression of the left renal vein.&amp;lt;ref name=Medscape/&amp;gt; &lt;br /&gt;
*Portal venous pneumatosis&amp;lt;ref name=Medscape/&amp;gt;&lt;br /&gt;
*Abdominal aortic aneurysm,&amp;lt;ref name=Medscape/&amp;gt; see [[CT of abdominal aortic aneurysm]].&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Rectal_cancer&amp;diff=3963</id>
		<title>Rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Rectal_cancer&amp;diff=3963"/>
		<updated>2020-10-30T22:42:05Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Castilhos]]&lt;br /&gt;
|author2=Authors of integrated Creative Commons article&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;&amp;gt;{{cite journal|last1=Beets-Tan|first1=Regina G. H.|last2=Lambregts|first2=Doenja M. J.|last3=Maas|first3=Monique|last4=Bipat|first4=Shandra|last5=Barbaro|first5=Brunella|last6=Curvo-Semedo|first6=Luís|last7=Fenlon|first7=Helen M.|last8=Gollub|first8=Marc J.|last9=Gourtsoyianni|first9=Sofia|last10=Halligan|first10=Steve|last11=Hoeffel|first11=Christine|last12=Kim|first12=Seung Ho|last13=Laghi|first13=Andrea|last14=Maier|first14=Andrea|last15=Rafaelsen|first15=Søren R.|last16=Stoker|first16=Jaap|last17=Taylor|first17=Stuart A.|last18=Torkzad|first18=Michael R.|last19=Blomqvist|first19=Lennart|title=Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting|journal=European Radiology|volume=28|issue=4|year=2017|pages=1465–1475|issn=0938-7994|doi=10.1007/s00330-017-5026-2}}&amp;lt;/ref&amp;gt;&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
==Planning==&lt;br /&gt;
{{Rectal cancer - choice of modality}}&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Steatosis&amp;diff=3962</id>
		<title>Steatosis</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Steatosis&amp;diff=3962"/>
		<updated>2020-10-30T22:41:33Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|author2=[[User:Rhcastilhos|Rodrigo Castilhos]]&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
==Planning==&lt;br /&gt;
{{Steatosis - choice of modality}}&lt;br /&gt;
{{Steatosis - how soon}}&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=CT_of_abdominal_aortic_aneurysm&amp;diff=3961</id>
		<title>CT of abdominal aortic aneurysm</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=CT_of_abdominal_aortic_aneurysm&amp;diff=3961"/>
		<updated>2020-10-30T22:41:20Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
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&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Castilhos]]&lt;br /&gt;
|author2=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|author3=&lt;br /&gt;
}}&lt;br /&gt;
Because it is a widely available, rapid imaging method, computed tomography (CT) angiography is the exam of choice in such cases.&amp;lt;ref name=&amp;quot;CorrêaAlves2019&amp;quot;&amp;gt;{{cite journal|last1=Corrêa|first1=Ingrid Braga|last2=Alves|first2=Bruna Leal Torres|last3=Oliveira Sobrinho|first3=Tarcísio Angelo de|last4=Ramos|first4=Laura Filgueiras Mourão|last5=Diniz|first5=Renata Lopes Furletti Caldeira|last6=Ribeiro|first6=Marcelo Almeida|title=Abdominal aortic aneurysms that have ruptured or are at imminent risk of rupture|journal=Radiologia Brasileira|volume=52|issue=3|year=2019|pages=182–186|issn=1678-7099|doi=10.1590/0100-3984.2017.0096}}&amp;lt;/ref&amp;gt;&lt;br /&gt;
&lt;br /&gt;
== Planning==&lt;br /&gt;
{{Abdominal aneurysm - Choice of modality}}&lt;br /&gt;
&lt;br /&gt;
==Evaluation==&lt;br /&gt;
&lt;br /&gt;
===Size classification===&lt;br /&gt;
{{Diameters of abdominal aorta}}&lt;br /&gt;
Abdominal aortic aneurysms are commonly divided according to their size and symptomatology. An aneurysm is usually defined as an outer aortic diameter over 3&amp;amp;nbsp;cm (normal diameter of the aorta is around 2&amp;amp;nbsp;cm),&amp;lt;ref name=ACC2005&amp;gt;{{cite journal |vauthors=Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B | title = ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease)—summary of recommendations | journal = J Vasc Interv Radiol | volume = 17 | issue = 9 | pages = 1383–97; quiz 1398 | date = September 2006 | pmid = 16990459 | doi = 10.1097/01.RVI.0000240426.53079.46 }}&amp;lt;/ref&amp;gt; or more than 50% of normal diameter.&amp;lt;ref name=&amp;quot;SolomonKent2014&amp;quot;&amp;gt;{{cite journal|last1=Solomon|first1=Caren G.|last2=Kent|first2=K. Craig|title=Abdominal Aortic Aneurysms|journal=New England Journal of Medicine|volume=371|issue=22|year=2014|pages=2101–2108|issn=0028-4793|doi=10.1056/NEJMcp1401430|pmid=25427112}}&amp;lt;/ref&amp;gt; The suprarenal aorta normally measures about 0.5 cm larger than the infrarenal aorta.&amp;lt;ref&amp;gt;{{cite web|url=https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-abdominal-aortic-aneurysm|title=Clinical features and diagnosis of abdominal aortic aneurysm|author=Jeffrey Jim, Robert W Thompson|website=[[UpToDate]]|date=2018-03-05|deadurl=no|archiveurl=https://web.archive.org/web/20180330212246/https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-abdominal-aortic-aneurysm|archivedate=2018-03-30|df=}}&amp;lt;/ref&amp;gt;&lt;br /&gt;
&lt;br /&gt;
=== Signs of rupture ===&lt;br /&gt;
* Retroperitoneal hematoma (most common): translates to a loss of aneurysmal wall integrity and appears on CT as a periaortic focus of soft-tissue density. The hematoma can extend into the pararenal and perirenal spaces, as well as to the psoas muscle and into the intraperitoneal space. In contrast-enhanced images, active extravasation of the contrast agent can be seen.&amp;lt;ref name=&amp;quot;CorrêaAlves2019&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* [[Draped aorta sign]]: in cases of a ruptured aneurysm contained, neighboring structures such as the vertebral bodies or adjacent retroperitoneal tissues buffer the hemorrhage and the patient may remain hemodynamically stable(1). A CT scan of a contained rupture can show the draped aorta sign, in which neither the posterior wall of the aorta nor the periaortic fat plane is distinguishable.&amp;lt;ref name=&amp;quot;CorrêaAlves2019&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
===Signs of imminent rupture===&lt;br /&gt;
* The maximum diameter and growth rate of an aneurysm are the most common predictors of its rupture, underscoring the importance of serial imaging in the follow-up of patients with an AAA. In most cases of typical fusiform aneurysms, a surgical approach is indicated if the aneurysm diameter is &amp;gt; 5.4 cm or the aneurysm grows by more than 5 mm over a six-month period.&amp;lt;ref name=&amp;quot;CorrêaAlves2019&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* [[Hyperattenuating crescent sign]]: corresponds to a hyperattenuating peripheral area within the wall of the aorta or within a mural thrombus, indicating infiltration of blood from the lumen of the aneurysm into those structures, with consequent weakening of the wall of the aneurysm. The hyperattenuating crescent sign is best visualized on unenhanced CT scans and is characterized by attenuation greater than that of intraluminal blood.&amp;lt;ref name=&amp;quot;CorrêaAlves2019&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Focal discontinuity of parietal circumferential calcification: can indicate that an aneurysm is unstable. That is especially relevant when the discontinuity is new or there are new outpouchings.&amp;lt;ref name=&amp;quot;CorrêaAlves2019&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Penetrating atherosclerotic ulcers: although less common in AAAs than in thoracic aortic aneurysms, they also indicates that an aneurysm is unstable. The expansion of such ulcers increases the risk of outpouching and rupture.&amp;lt;ref name=&amp;quot;CorrêaAlves2019&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
==Reporting==&lt;br /&gt;
{{Reporting}}&lt;br /&gt;
&lt;br /&gt;
== Communication ==&lt;br /&gt;
&lt;br /&gt;
Abdominal aortic aneurysm rupture is a medical emergency associated with extremely high mortality and therefore requiring immediate surgical treatment.  Referring doctor should be contacted.&amp;lt;ref name=&amp;quot;CorrêaAlves2019&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
==See also==&lt;br /&gt;
*[[CT of abdominal aneurysm]]&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3960</id>
		<title>MRI of the liver</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3960"/>
		<updated>2020-10-30T22:41:02Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Castilhos]]&lt;br /&gt;
|author2=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
[[File:MRI of Caroli disease (d).jpg|right]]&lt;br /&gt;
&lt;br /&gt;
==Planning==&lt;br /&gt;
{{Liver - choice of modality}}&lt;br /&gt;
&lt;br /&gt;
===Technique===&lt;br /&gt;
Requires a phased array torso [[coil]].&lt;br /&gt;
&lt;br /&gt;
==Basic screening==&lt;br /&gt;
*'''Morphology''': verify size, borders and contours.&lt;br /&gt;
*'''Liver parenchyma''': Scan for steatosis, iron deposition&lt;br /&gt;
*'''Focal lesions''': Scan for nodules&lt;br /&gt;
*'''Biliary ducts''':&lt;br /&gt;
*'''Hepatic veins'''&lt;br /&gt;
*'''Portal vein'''&lt;br /&gt;
&lt;br /&gt;
'''Search for extrahepatic findings'''&lt;br /&gt;
*'''Lymph''' nodes in hepatic hilum.&lt;br /&gt;
*Signs of portal hypertension: [[ascites]], [[splenomegaly]]; portosystemic collateral vessels&lt;br /&gt;
&lt;br /&gt;
==Report==&lt;br /&gt;
&lt;br /&gt;
[[LI-RADS]] (Liver Imaging and Reporting Data System) system should be used only if patient has a high risk for hepatocellular carcinoma (cirrhosis, chronic hepatitis B or current/prior HCC).&lt;br /&gt;
{{Reporting}}&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
[[Category:Liver]]&lt;br /&gt;
[[Category:MRI]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_perianal_fistula&amp;diff=3959</id>
		<title>MRI of perianal fistula</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_perianal_fistula&amp;diff=3959"/>
		<updated>2020-10-30T22:40:41Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
== Epidemiology ==&lt;br /&gt;
*Uncommon condition&lt;br /&gt;
*High morbitidy&lt;br /&gt;
*Men (2:1)&lt;br /&gt;
*Young adults&lt;br /&gt;
&lt;br /&gt;
== Technique ==&lt;br /&gt;
*Edema sequences: STIR, T2 FS&lt;br /&gt;
*Enhancement sequence: T1 FS&lt;br /&gt;
&lt;br /&gt;
== Classification ==&lt;br /&gt;
&lt;br /&gt;
St. Jame's classification&lt;br /&gt;
* Type 1: simple linear intersphincteric fistula&lt;br /&gt;
* Type 2: intersphincteric fistula with abscess or secondary tract&lt;br /&gt;
* Type 3: trans-sphincteric fistula&lt;br /&gt;
* Type 4: trans-sphincteric fistula with formation of abscess or secondary tract within the ischioanal fossa&lt;br /&gt;
* Type 5: suprasphincteric or extrasphincteric fistula&lt;br /&gt;
&lt;br /&gt;
== Complexity== &lt;br /&gt;
&lt;br /&gt;
*Simple&lt;br /&gt;
*Complex&lt;br /&gt;
&lt;br /&gt;
== Characteristics ==&lt;br /&gt;
* Internal opening: location (clock), high vs low.&lt;br /&gt;
* External opening: location (clock), location (perineum, natal cleft), distance to anal margin&lt;br /&gt;
* Involvement of other structures&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Superior_mesenteric_artery_syndrome&amp;diff=3958</id>
		<title>Superior mesenteric artery syndrome</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Superior_mesenteric_artery_syndrome&amp;diff=3958"/>
		<updated>2020-10-30T22:40:29Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Castilhos]]&lt;br /&gt;
|author2=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|author3=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
Also known as Wilkie's syndrome, this condition occurs when the third part of the duodenum is compressed between the superior mesenteric artery and the aorta. Under normal conditions, there is retroperitoneal fat around the third part of the duodenum, which avoids compression by creating an aortomesenteric angle &amp;gt; 28º. &lt;br /&gt;
&lt;br /&gt;
==Planning==&lt;br /&gt;
{{Superior mesenteric artery syndrome - Indications and choice of modality}}&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3957</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3957"/>
		<updated>2020-10-30T22:39:35Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Castilhos]]&lt;br /&gt;
|author2=Authors of integrated Creative Commons article&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;&amp;gt;{{cite journal|last1=Beets-Tan|first1=Regina G. H.|last2=Lambregts|first2=Doenja M. J.|last3=Maas|first3=Monique|last4=Bipat|first4=Shandra|last5=Barbaro|first5=Brunella|last6=Curvo-Semedo|first6=Luís|last7=Fenlon|first7=Helen M.|last8=Gollub|first8=Marc J.|last9=Gourtsoyianni|first9=Sofia|last10=Halligan|first10=Steve|last11=Hoeffel|first11=Christine|last12=Kim|first12=Seung Ho|last13=Laghi|first13=Andrea|last14=Maier|first14=Andrea|last15=Rafaelsen|first15=Søren R.|last16=Stoker|first16=Jaap|last17=Taylor|first17=Stuart A.|last18=Torkzad|first18=Michael R.|last19=Blomqvist|first19=Lennart|title=Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting|journal=European Radiology|volume=28|issue=4|year=2017|pages=1465–1475|issn=0938-7994|doi=10.1007/s00330-017-5026-2}}&amp;lt;/ref&amp;gt;&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a practical summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
==Planning==&lt;br /&gt;
{{Rectal cancer - choice of modality}}&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
* Requires an external surface coil&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
* 1.5T or 3.0T.&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
&lt;br /&gt;
* Use of an enema is not routinely recommended&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
'''Spasmolytics (optional)'''&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduces susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI and ADC maps should be assessed visually (not quantitatively)&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
&lt;br /&gt;
All tumours:&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
&lt;br /&gt;
Distal tumours:&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Include coronal sequence parallel to the anal canal to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
{{Reporting}}&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
&lt;br /&gt;
==== Morphology ====&lt;br /&gt;
&lt;br /&gt;
Morphology&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Solid - polypoid&lt;br /&gt;
* Solid - (semi-)annular&lt;br /&gt;
* Mucinous&lt;br /&gt;
&lt;br /&gt;
Circunferential location within the rectal wall&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* e.g. from X to X o'clock&lt;br /&gt;
* Should routinely be reported&lt;br /&gt;
&lt;br /&gt;
==== Distance from anorectal junction ====&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
There is agreement that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility.&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
*'''T3: extramural growth''' (including growth into the internal anal sphincter muscle)&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
* '''T4'''&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
**T4a: Invasion of peritoneal reflection&lt;br /&gt;
**T4b: Invasion of surrounding organs&lt;br /&gt;
&lt;br /&gt;
Observations:&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Stranding into mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
For low tumours with sphincter invasion, describe:&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* invades only the internal sphincter muscle (T3)&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
** below: MRF invasion&lt;br /&gt;
** above: when on anterior side = at risk for peritoneal invasion (rather than MRF invasion)&lt;br /&gt;
&lt;br /&gt;
Observations:&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
*  Mesorectal fascia involvement:&lt;br /&gt;
** Shortest distance between tumour and MRF&lt;br /&gt;
*** Free: &amp;gt;2 mm&lt;br /&gt;
*** Threatened: 1.1-2 mm&lt;br /&gt;
*** Involved (=T3): ≤1 mm or stranding into the MRF&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
&lt;br /&gt;
* Important risk factor for local recurrence&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
* EMVI is an important prognostic staging factor&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
&lt;br /&gt;
* Structured reporting is recommended&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
T2W&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* '''No residual tumour mass'''&lt;br /&gt;
** '''Complete response''': a normalised, two-layered rectal wall&lt;br /&gt;
** '''Complete or near-complete response''': a completely hypointense residue (fibrotic wall thickening) without clear residual isointense mass&lt;br /&gt;
* '''Residual tumour mass''' (and/or focal high sinal on DWI)&lt;br /&gt;
** yT-stage: yT1-2&lt;br /&gt;
** yT3&lt;br /&gt;
*** yT3a or yT3b (≤5 mm extramural growth)&lt;br /&gt;
*** yT3c or yT3d (&amp;gt;5 mm extramural growth)&lt;br /&gt;
**yT4, based on growth into:&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour (in cm)&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
* Tumour length (in cm)&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
*Sphincter invasion&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
For low tumours with sphincter invasion, describe:&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
Restaging after long course neoadjuvant treatment + downstaging interval&amp;lt;ref name=&amp;quot;Beets-TanLambregts2017&amp;quot;/&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* Benign nodes: Short axis diameter &amp;lt;5 mm &lt;br /&gt;
* Malign nodes: Short axis diameter ≥5 mm&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=User_talk:Mikael_H%C3%A4ggstr%C3%B6m&amp;diff=3626</id>
		<title>User talk:Mikael Häggström</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=User_talk:Mikael_H%C3%A4ggstr%C3%B6m&amp;diff=3626"/>
		<updated>2019-07-16T16:15:31Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Some errors */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;==Task: Copying children’s X-ray pictures==&lt;br /&gt;
The task here is to copy X-ray images of children of various ages from bonepit.com (http://bonepit.com/Normal%20for%20age/Normal%20for%20age%20index.htm) to the corresponding articles in [https://radlines.org/Main radlines.org]:&lt;br /&gt;
&lt;br /&gt;
*Hand: https://radlines.org/Normal_X-rays_of_the_hand_at_0_to_20_years (currently takes some time to load)&lt;br /&gt;
*Wrist: https://radlines.org/X-ray_of_the_wrist&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
*Cx spine: https://radlines.org/X-ray_of_the_cervical_spine&lt;br /&gt;
&lt;br /&gt;
*Pelvis: https://radlines.org/Normal_X-rays_of_the_pelvic_bones_at_0_to_20_years&lt;br /&gt;
&lt;br /&gt;
I've already completed the images for the thumb, &lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
1. I will provide you with login details to an account you can use to edit pages&lt;br /&gt;
&amp;lt;br&amp;gt;2. Continue with the table of the hand: https://radlines.org/Normal_X-rays_of_the_hand_at_0_to_20_years&lt;br /&gt;
:2.1. Go to http://bonepit.com/Normal%20for%20age/Normal%20for%20age%20index.htm and download images to your computer. The next one is &amp;quot;10M Hand&amp;quot; (10 year old male, hand). You may start with one image, and then go through the rest of the process with that one. When you feel familiar with the steps, you may download a dozen of images at the same time.&lt;br /&gt;
:2.2. Look at the outline of the table in Radlines, and follow the same naming convention (the next image will be named &amp;quot;File:X-ray of the hand of a 10 year old male - dorsoplantar.jpg&amp;quot;): https://radlines.org/Normal_X-rays_of_the_hand_at_0_to_20_years&lt;br /&gt;
:2.3. Go to: https://commons.wikimedia.org/wiki/Special:UploadWizard&lt;br /&gt;
:2.4. Click &amp;quot;Select media files to share&amp;quot;&lt;br /&gt;
:2.5. Select the images on your computer&lt;br /&gt;
:2.6. Click &amp;quot;Continue&amp;quot;&lt;br /&gt;
:2.7. Click &amp;quot;Next&amp;quot;&lt;br /&gt;
:2.8&lt;br /&gt;
&lt;br /&gt;
== Some errors ==&lt;br /&gt;
&lt;br /&gt;
Hi, &lt;br /&gt;
&lt;br /&gt;
I can't edit with VisualEditor. I get the following error:&lt;br /&gt;
&lt;br /&gt;
''You're not allowed to edit this wiki through the API.''&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
When I go to [[Special:Preferences]], I get:&lt;br /&gt;
&lt;br /&gt;
''Warning: array_key_exists() expects parameter 2 to be array, null given in /home/radviser/www/www/extensions/UploadWizard/UploadWizardHooks.php on line 217&lt;br /&gt;
Hilfe&lt;br /&gt;
Interner Fehler&lt;br /&gt;
[XSkSVDeiK8Qus638G@b1ZQAAAAE] /Special:Preferences InvalidArgumentException from line 260 of /home/radviser/www/www/includes/Message.php: $key must be a string or an array&lt;br /&gt;
&lt;br /&gt;
Backtrace:&lt;br /&gt;
&lt;br /&gt;
#0 /home/radviser/www/www/includes/GlobalFunctions.php(1419): Message-&amp;gt;__construct(NULL)&lt;br /&gt;
#1 /home/radviser/www/www/extensions/UploadWizard/UploadWizardHooks.php(224): wfMessage(NULL)&lt;br /&gt;
#2 /home/radviser/www/www/extensions/UploadWizard/UploadWizardHooks.php(76): UploadWizardHooks::getLicenseMessage(string, array)&lt;br /&gt;
#3 /home/radviser/www/www/includes/Hooks.php(177): UploadWizardHooks::onGetPreferences(User, array)&lt;br /&gt;
#4 /home/radviser/www/www/includes/Hooks.php(205): Hooks::callHook(string, array, array, NULL)&lt;br /&gt;
#5 /home/radviser/www/www/includes/Preferences.php(98): Hooks::run(string, array)&lt;br /&gt;
#6 /home/radviser/www/www/includes/Preferences.php(1356): Preferences::getPreferences(User, RequestContext)&lt;br /&gt;
#7 /home/radviser/www/www/includes/specials/SpecialPreferences.php(127): Preferences::getFormObject(User, RequestContext)&lt;br /&gt;
#8 /home/radviser/www/www/includes/specials/SpecialPreferences.php(84): SpecialPreferences-&amp;gt;getFormObject(User, RequestContext)&lt;br /&gt;
#9 /home/radviser/www/www/includes/specialpage/SpecialPage.php(522): SpecialPreferences-&amp;gt;execute(NULL)&lt;br /&gt;
#10 /home/radviser/www/www/includes/specialpage/SpecialPageFactory.php(578): SpecialPage-&amp;gt;run(NULL)&lt;br /&gt;
#11 /home/radviser/www/www/includes/MediaWiki.php(287): SpecialPageFactory::executePath(Title, RequestContext)&lt;br /&gt;
#12 /home/radviser/www/www/includes/MediaWiki.php(851): MediaWiki-&amp;gt;performRequest()&lt;br /&gt;
#13 /home/radviser/www/www/includes/MediaWiki.php(523): MediaWiki-&amp;gt;main()&lt;br /&gt;
#14 /home/radviser/www/www/index.php(43): MediaWiki-&amp;gt;run()&lt;br /&gt;
#15 {main}&lt;br /&gt;
''&lt;br /&gt;
&lt;br /&gt;
--[[User:Rhcastilhos|Rhcastilhos]] ([[User talk:Rhcastilhos|talk]]) 02:09, 13 July 2019 (EEST)&lt;br /&gt;
&lt;br /&gt;
:Hi [[User:Rhcastilhos|Rhcastilhos]],&lt;br /&gt;
:I did not find the cause of this myself, so I have now emailed the host of the VisualEditor server about the issue. [[User:Mikael Häggström|Mikael Häggström]] ([[User talk:Mikael Häggström|talk]]) 11:12, 14 July 2019 (EEST)&lt;br /&gt;
:Best regards,&lt;br /&gt;
:[[User:Mikael Häggström|Mikael Häggström]] ([[User talk:Mikael Häggström|talk]]) 11:12, 14 July 2019 (EEST)&lt;br /&gt;
&lt;br /&gt;
:: VisualEditor is now working fine. &lt;br /&gt;
:: Another problem: I'm receiving a welcome message (&amp;quot;Welcome to radlines.org&amp;quot;) everytime I open the editor (VisualEditor or source editor). It seems to me that it should appear only the first time users open the editor, and I can't get rid of it (there is no &amp;quot;don't show me this message again&amp;quot; option).&lt;br /&gt;
:: [[User:Rhcastilhos|Rhcastilhos]] ([[User talk:Rhcastilhos|talk]]) 19:15, 16 July 2019 (EEST)&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3625</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3625"/>
		<updated>2019-07-16T16:05:02Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Testing VisualEditor&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a practical summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Requires an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
&lt;br /&gt;
* may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
&lt;br /&gt;
* Not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduces susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&lt;br /&gt;
&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI and ADC maps should be assessed visually (not quantitatively)&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
&lt;br /&gt;
All tumours:&lt;br /&gt;
&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
&lt;br /&gt;
Distal tumours:&lt;br /&gt;
&lt;br /&gt;
* Include coronal sequence parallel to the anal canal to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
&lt;br /&gt;
==== Morphology ====&lt;br /&gt;
&lt;br /&gt;
Morphology&lt;br /&gt;
&lt;br /&gt;
* Solid - polypoid&lt;br /&gt;
* Solid - (semi-)annular&lt;br /&gt;
* Mucinous&lt;br /&gt;
&lt;br /&gt;
Circunferential location within the rectal wall&lt;br /&gt;
&lt;br /&gt;
* e.g. from X to X o'clock&lt;br /&gt;
* Should routinely be reported&lt;br /&gt;
&lt;br /&gt;
==== Distance from anorectal junction ====&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
Although the panel agreed unanimously that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility.&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
*'''T3: extramural growth''' (including growth into the internal anal sphincter muscle)&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
**T4a: Invasion of peritoneal reflection&lt;br /&gt;
**T4b: Invasion of surrounding organs&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
&lt;br /&gt;
* Stranding into mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
&lt;br /&gt;
* invades only the internal sphincter muscle (T3)&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&lt;br /&gt;
** below: MRF invasion&lt;br /&gt;
** above: when on anterior side = at risk for peritoneal invasion (rather than MRF invasion)&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
&lt;br /&gt;
* The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
*  Mesorectal fascia involvement:&lt;br /&gt;
** Shortest distance between tumour and MRF&lt;br /&gt;
*** Free: &amp;gt;2 mm&lt;br /&gt;
*** Threatened: 1.1-2 mm&lt;br /&gt;
*** Involved (=T3): ≤1 mm or stranding into the MRF&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&lt;br /&gt;
* EMVI is an important prognostic staging factor&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
T2W&lt;br /&gt;
&lt;br /&gt;
* '''No residual tumour mass'''&lt;br /&gt;
** '''Complete response''': a normalised, two-layered rectal wall&lt;br /&gt;
** '''Complete or near-complete response''': a completely hypointense residue (fibrotic wall thickening) without clear residual isointense mass&lt;br /&gt;
* '''Residual tumour mass''' (and/or focal high sinal on DWI)&lt;br /&gt;
** yT-stage: yT1-2&lt;br /&gt;
** yT3&lt;br /&gt;
*** yT3a or yT3b (≤5 mm extramural growth)&lt;br /&gt;
*** yT3c or yT3d (&amp;gt;5 mm extramural growth)&lt;br /&gt;
**yT4, based on growth into:&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour (in cm)&lt;br /&gt;
* Tumour length (in cm)&lt;br /&gt;
&lt;br /&gt;
*Sphincter invasion&lt;br /&gt;
&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
Restaging after long course neoadjuvant treatment + downstaging interval&lt;br /&gt;
&lt;br /&gt;
* Benign nodes: Short axis diameter &amp;lt;5 mm &lt;br /&gt;
* Malign nodes: Short axis diameter ≥5 mm&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3624</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3624"/>
		<updated>2019-07-16T16:02:24Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Testing VisualEditor&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a practical summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Requires an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
&lt;br /&gt;
* may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
&lt;br /&gt;
* Not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduces susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&lt;br /&gt;
&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI and ADC maps should be assessed visually&lt;br /&gt;
** Quantitative ADC measurements are not routinely advised&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
&lt;br /&gt;
All tumours:&lt;br /&gt;
&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
&lt;br /&gt;
Distal tumours:&lt;br /&gt;
&lt;br /&gt;
* Include coronal sequence parallel to the anal canal to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
&lt;br /&gt;
==== Morphology ====&lt;br /&gt;
&lt;br /&gt;
Morphology&lt;br /&gt;
&lt;br /&gt;
* Solid - polypoid&lt;br /&gt;
* Solid - (semi-)annular&lt;br /&gt;
* Mucinous&lt;br /&gt;
&lt;br /&gt;
Circunferential location within the rectal wall&lt;br /&gt;
&lt;br /&gt;
* e.g. from X to X o'clock&lt;br /&gt;
* Should routinely be reported&lt;br /&gt;
&lt;br /&gt;
==== Distance from anorectal junction ====&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
Although the panel agreed unanimously that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility.&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
*'''T3: extramural growth''' (including growth into the internal anal sphincter muscle)&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
**T4a: Invasion of peritoneal reflection&lt;br /&gt;
**T4b: Invasion of surrounding organs&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
&lt;br /&gt;
* Stranding into mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
&lt;br /&gt;
* invades only the internal sphincter muscle (T3)&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&lt;br /&gt;
** below: MRF invasion&lt;br /&gt;
** above: when on anterior side = at risk for peritoneal invasion (rather than MRF invasion)&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
&lt;br /&gt;
* The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
*  Mesorectal fascia involvement:&lt;br /&gt;
** Shortest distance between tumour and MRF&lt;br /&gt;
*** Free: &amp;gt;2 mm&lt;br /&gt;
*** Threatened: 1.1-2 mm&lt;br /&gt;
*** Involved (=T3): ≤1 mm or stranding into the MRF&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&lt;br /&gt;
* EMVI is an important prognostic staging factor&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
T2W&lt;br /&gt;
&lt;br /&gt;
* '''No residual tumour mass'''&lt;br /&gt;
** '''Complete response''': a normalised, two-layered rectal wall&lt;br /&gt;
** '''Complete or near-complete response''': a completely hypointense residue (fibrotic wall thickening) without clear residual isointense mass&lt;br /&gt;
* '''Residual tumour mass''' (and/or focal high sinal on DWI)&lt;br /&gt;
** yT-stage: yT1-2&lt;br /&gt;
** yT3&lt;br /&gt;
*** yT3a or yT3b (≤5 mm extramural growth)&lt;br /&gt;
*** yT3c or yT3d (&amp;gt;5 mm extramural growth)&lt;br /&gt;
**yT4, based on growth into:&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour (in cm)&lt;br /&gt;
* Tumour length (in cm)&lt;br /&gt;
&lt;br /&gt;
*Sphincter invasion&lt;br /&gt;
&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
Restaging after long course neoadjuvant treatment + downstaging interval&lt;br /&gt;
&lt;br /&gt;
* Benign nodes: Short axis diameter &amp;lt;5 mm &lt;br /&gt;
* Malign nodes: Short axis diameter ≥5 mm&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3602</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3602"/>
		<updated>2019-07-15T21:51:35Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Lymph nodes and tumour deposits */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a practical summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Requires an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
* Not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduces susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI and ADC maps should be assessed visually&lt;br /&gt;
** Quantitative ADC measurements are not routinely advised&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
&lt;br /&gt;
All tumours:&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
Distal tumours:&lt;br /&gt;
* Include coronal sequence parallel to the anal canal to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
&lt;br /&gt;
==== Morphology ====&lt;br /&gt;
&lt;br /&gt;
Morphology&lt;br /&gt;
* Solid - polypoid&lt;br /&gt;
* Solid - (semi-)annular&lt;br /&gt;
* Mucinous&lt;br /&gt;
&lt;br /&gt;
Circunferential location within the rectal wall&lt;br /&gt;
* e.g. from X to X o'clock&lt;br /&gt;
* Should routinely be reported&lt;br /&gt;
&lt;br /&gt;
==== Distance from anorectal junction ====&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
Although the panel agreed unanimously that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable [23]. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility [20, 23, 24].&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
*'''T3: extramural growth''' (including growth into the internal anal sphincter muscle)&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
**T4a: Invasion of peritoneal reflection&lt;br /&gt;
**T4b: Invasion of surrounding organs&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* Stranding into mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle (T3)&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&lt;br /&gt;
** below: MRF invasion&lt;br /&gt;
** above: when on anterior side = at risk for peritoneal invasion (rather than MRF invasion)&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
*  Mesorectal fascia involvement:&lt;br /&gt;
** Shortest distance between tumour and MRF&lt;br /&gt;
*** Free: &amp;gt;2 mm&lt;br /&gt;
*** Threatened: 1.1-2 mm&lt;br /&gt;
*** Involved (=T3): ≤1 mm or stranding into the MRF&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&lt;br /&gt;
* EMVI is an important prognostic staging factor&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
T2W&lt;br /&gt;
* '''No residual tumour mass'''&lt;br /&gt;
** '''Complete response''': a normalised, two-layered rectal wall&lt;br /&gt;
** '''Complete or near-complete response''': a completely hypointense residue (fibrotic wall thickening) without clear residual isointense mass&lt;br /&gt;
* '''Residual tumour mass''' (and/or focal high sinal on DWI)&lt;br /&gt;
** yT-stage: yT1-2&lt;br /&gt;
** yT3&lt;br /&gt;
*** yT3a or yT3b (≤5 mm extramural growth)&lt;br /&gt;
*** yT3c or yT3d (&amp;gt;5 mm extramural growth)&lt;br /&gt;
**yT4, based on growth into:&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour (in cm)&lt;br /&gt;
* Tumour length (in cm)&lt;br /&gt;
&lt;br /&gt;
*Sphincter invasion&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
Restaging after long course neoadjuvant treatment + downstaging interval&lt;br /&gt;
&lt;br /&gt;
* Benign nodes: Short axis diameter &amp;lt;5 mm &lt;br /&gt;
* Malign nodes: Short axis diameter ≥5 mm&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3601</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3601"/>
		<updated>2019-07-15T21:49:34Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Sequences and sequence angulation */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a practical summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Requires an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
* Not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduces susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI and ADC maps should be assessed visually&lt;br /&gt;
** Quantitative ADC measurements are not routinely advised&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
&lt;br /&gt;
All tumours:&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
Distal tumours:&lt;br /&gt;
* Include coronal sequence parallel to the anal canal to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
&lt;br /&gt;
==== Morphology ====&lt;br /&gt;
&lt;br /&gt;
Morphology&lt;br /&gt;
* Solid - polypoid&lt;br /&gt;
* Solid - (semi-)annular&lt;br /&gt;
* Mucinous&lt;br /&gt;
&lt;br /&gt;
Circunferential location within the rectal wall&lt;br /&gt;
* e.g. from X to X o'clock&lt;br /&gt;
* Should routinely be reported&lt;br /&gt;
&lt;br /&gt;
==== Distance from anorectal junction ====&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
Although the panel agreed unanimously that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable [23]. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility [20, 23, 24].&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
*'''T3: extramural growth''' (including growth into the internal anal sphincter muscle)&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
**T4a: Invasion of peritoneal reflection&lt;br /&gt;
**T4b: Invasion of surrounding organs&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* Stranding into mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle (T3)&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&lt;br /&gt;
** below: MRF invasion&lt;br /&gt;
** above: when on anterior side = at risk for peritoneal invasion (rather than MRF invasion)&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
*  Mesorectal fascia involvement:&lt;br /&gt;
** Shortest distance between tumour and MRF&lt;br /&gt;
*** Free: &amp;gt;2 mm&lt;br /&gt;
*** Threatened: 1.1-2 mm&lt;br /&gt;
*** Involved (=T3): ≤1 mm or stranding into the MRF&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&lt;br /&gt;
* EMVI is an important prognostic staging factor&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
T2W&lt;br /&gt;
* '''No residual tumour mass'''&lt;br /&gt;
** '''Complete response''': a normalised, two-layered rectal wall&lt;br /&gt;
** '''Complete or near-complete response''': a completely hypointense residue (fibrotic wall thickening) without clear residual isointense mass&lt;br /&gt;
* '''Residual tumour mass''' (and/or focal high sinal on DWI)&lt;br /&gt;
** yT-stage: yT1-2&lt;br /&gt;
** yT3&lt;br /&gt;
*** yT3a or yT3b (≤5 mm extramural growth)&lt;br /&gt;
*** yT3c or yT3d (&amp;gt;5 mm extramural growth)&lt;br /&gt;
**yT4, based on growth into:&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour (in cm)&lt;br /&gt;
* Tumour length (in cm)&lt;br /&gt;
&lt;br /&gt;
*Sphincter invasion&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
Restaging after long course neoadjuvant treatment + downstaging interval&lt;br /&gt;
&lt;br /&gt;
* Benign nodes: Short axis diameter &amp;lt;5 mm &lt;br /&gt;
* Malign nodes: Short axis diameter ≥5 mm&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3600</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3600"/>
		<updated>2019-07-15T21:32:22Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Patient preparation */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a practical summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Requires an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
* Not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduces susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI images (including ADC maps) should mainly be assessed visually&lt;br /&gt;
** Quantitative ADC measurements are not routinely advised&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage.&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
* Coronal sequence parallel to the anal canal: should be included in distal tumours to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
&lt;br /&gt;
==== Morphology ====&lt;br /&gt;
&lt;br /&gt;
Morphology&lt;br /&gt;
* Solid - polypoid&lt;br /&gt;
* Solid - (semi-)annular&lt;br /&gt;
* Mucinous&lt;br /&gt;
&lt;br /&gt;
Circunferential location within the rectal wall&lt;br /&gt;
* e.g. from X to X o'clock&lt;br /&gt;
* Should routinely be reported&lt;br /&gt;
&lt;br /&gt;
==== Distance from anorectal junction ====&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
Although the panel agreed unanimously that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable [23]. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility [20, 23, 24].&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
*'''T3: extramural growth''' (including growth into the internal anal sphincter muscle)&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
**T4a: Invasion of peritoneal reflection&lt;br /&gt;
**T4b: Invasion of surrounding organs&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* Stranding into mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle (T3)&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&lt;br /&gt;
** below: MRF invasion&lt;br /&gt;
** above: when on anterior side = at risk for peritoneal invasion (rather than MRF invasion)&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
*  Mesorectal fascia involvement:&lt;br /&gt;
** Shortest distance between tumour and MRF&lt;br /&gt;
*** Free: &amp;gt;2 mm&lt;br /&gt;
*** Threatened: 1.1-2 mm&lt;br /&gt;
*** Involved (=T3): ≤1 mm or stranding into the MRF&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&lt;br /&gt;
* EMVI is an important prognostic staging factor&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
T2W&lt;br /&gt;
* '''No residual tumour mass'''&lt;br /&gt;
** '''Complete response''': a normalised, two-layered rectal wall&lt;br /&gt;
** '''Complete or near-complete response''': a completely hypointense residue (fibrotic wall thickening) without clear residual isointense mass&lt;br /&gt;
* '''Residual tumour mass''' (and/or focal high sinal on DWI)&lt;br /&gt;
** yT-stage: yT1-2&lt;br /&gt;
** yT3&lt;br /&gt;
*** yT3a or yT3b (≤5 mm extramural growth)&lt;br /&gt;
*** yT3c or yT3d (&amp;gt;5 mm extramural growth)&lt;br /&gt;
**yT4, based on growth into:&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour (in cm)&lt;br /&gt;
* Tumour length (in cm)&lt;br /&gt;
&lt;br /&gt;
*Sphincter invasion&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
Restaging after long course neoadjuvant treatment + downstaging interval&lt;br /&gt;
&lt;br /&gt;
* Benign nodes: Short axis diameter &amp;lt;5 mm &lt;br /&gt;
* Malign nodes: Short axis diameter ≥5 mm&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3599</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3599"/>
		<updated>2019-07-15T21:29:41Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a practical summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Requires an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
* Not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduce susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI images (including ADC maps) should mainly be assessed visually&lt;br /&gt;
** Quantitative ADC measurements are not routinely advised&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage.&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
* Coronal sequence parallel to the anal canal: should be included in distal tumours to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
&lt;br /&gt;
==== Morphology ====&lt;br /&gt;
&lt;br /&gt;
Morphology&lt;br /&gt;
* Solid - polypoid&lt;br /&gt;
* Solid - (semi-)annular&lt;br /&gt;
* Mucinous&lt;br /&gt;
&lt;br /&gt;
Circunferential location within the rectal wall&lt;br /&gt;
* e.g. from X to X o'clock&lt;br /&gt;
* Should routinely be reported&lt;br /&gt;
&lt;br /&gt;
==== Distance from anorectal junction ====&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
Although the panel agreed unanimously that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable [23]. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility [20, 23, 24].&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
*'''T3: extramural growth''' (including growth into the internal anal sphincter muscle)&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
**T4a: Invasion of peritoneal reflection&lt;br /&gt;
**T4b: Invasion of surrounding organs&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* Stranding into mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle (T3)&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&lt;br /&gt;
** below: MRF invasion&lt;br /&gt;
** above: when on anterior side = at risk for peritoneal invasion (rather than MRF invasion)&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
*  Mesorectal fascia involvement:&lt;br /&gt;
** Shortest distance between tumour and MRF&lt;br /&gt;
*** Free: &amp;gt;2 mm&lt;br /&gt;
*** Threatened: 1.1-2 mm&lt;br /&gt;
*** Involved (=T3): ≤1 mm or stranding into the MRF&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&lt;br /&gt;
* EMVI is an important prognostic staging factor&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
T2W&lt;br /&gt;
* '''No residual tumour mass'''&lt;br /&gt;
** '''Complete response''': a normalised, two-layered rectal wall&lt;br /&gt;
** '''Complete or near-complete response''': a completely hypointense residue (fibrotic wall thickening) without clear residual isointense mass&lt;br /&gt;
* '''Residual tumour mass''' (and/or focal high sinal on DWI)&lt;br /&gt;
** yT-stage: yT1-2&lt;br /&gt;
** yT3&lt;br /&gt;
*** yT3a or yT3b (≤5 mm extramural growth)&lt;br /&gt;
*** yT3c or yT3d (&amp;gt;5 mm extramural growth)&lt;br /&gt;
**yT4, based on growth into:&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour (in cm)&lt;br /&gt;
* Tumour length (in cm)&lt;br /&gt;
&lt;br /&gt;
*Sphincter invasion&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
Restaging after long course neoadjuvant treatment + downstaging interval&lt;br /&gt;
&lt;br /&gt;
* Benign nodes: Short axis diameter &amp;lt;5 mm &lt;br /&gt;
* Malign nodes: Short axis diameter ≥5 mm&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3598</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3598"/>
		<updated>2019-07-15T20:58:12Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Local tumour status */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Should use an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
* Use of spasmolytics may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Use of endorectal filling is not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI images (including ADC maps) should mainly be assessed visually&lt;br /&gt;
** Quantitative ADC measurements are not routinely advised&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage.&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
* Coronal sequence parallel to the anal canal: should be included in distal tumours to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Patient preparation ==&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduce susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
* Morphology&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
* Tumour length&lt;br /&gt;
* T-stage&lt;br /&gt;
* Sphincter invasion&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
Although the panel agreed unanimously that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable [23]. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility [20, 23, 24].&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
** Good prognosis&lt;br /&gt;
** Rectal wall has an intact black line (outer muscle) surrounding the tumor&lt;br /&gt;
*'''T3: extramural growth'''&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* Stranding into the mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* The mesorectal fascia (MRF) is 'involved' if the distance between MRF and tumour is ≤1 mm&lt;br /&gt;
* Stranding into the MRF = MRF is involved&lt;br /&gt;
* Involvement of MRF = T3&lt;br /&gt;
* Tumour invasion above the level of the peritoneal reflection (at the anterior side) should be considered at risk for peritoneal rather than MRF invasion&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&lt;br /&gt;
** below (MRF invasion)&lt;br /&gt;
** above&lt;br /&gt;
&lt;br /&gt;
The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment [20]. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&lt;br /&gt;
* EMVI is an important prognostic staging factor&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
T2W&lt;br /&gt;
* '''No residual tumour mass'''&lt;br /&gt;
** '''Complete response''': a normalised, two-layered rectal wall&lt;br /&gt;
** '''Complete or near-complete response''': a completely hypointense residue (fibrotic wall thickening) without clear residual isointense mass&lt;br /&gt;
* '''Residual tumour mass''' (and/or focal high sinal on DWI)&lt;br /&gt;
** yT-stage: yT1-2&lt;br /&gt;
** yT3&lt;br /&gt;
*** yT3a or yT3b (≤5 mm extramural growth)&lt;br /&gt;
*** yT3c or yT3d (&amp;gt;5 mm extramural growth)&lt;br /&gt;
**yT4, based on growth into:&lt;br /&gt;
&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour (in cm)&lt;br /&gt;
* Tumour length (in cm)&lt;br /&gt;
&lt;br /&gt;
*Sphincter invasion&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
Restaging after long course neoadjuvant treatment + downstaging interval&lt;br /&gt;
&lt;br /&gt;
* Benign nodes: Short axis diameter &amp;lt;5 mm &lt;br /&gt;
* Malign nodes: Short axis diameter ≥5 mm&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== N staging ==&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
== N restaging ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3597</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3597"/>
		<updated>2019-07-15T20:51:28Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Lymph nodes and tumour deposits */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Should use an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
* Use of spasmolytics may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Use of endorectal filling is not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI images (including ADC maps) should mainly be assessed visually&lt;br /&gt;
** Quantitative ADC measurements are not routinely advised&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage.&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
* Coronal sequence parallel to the anal canal: should be included in distal tumours to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Patient preparation ==&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduce susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
* Morphology&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
* Tumour length&lt;br /&gt;
* T-stage&lt;br /&gt;
* Sphincter invasion&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
Although the panel agreed unanimously that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable [23]. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility [20, 23, 24].&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
** Good prognosis&lt;br /&gt;
** Rectal wall has an intact black line (outer muscle) surrounding the tumor&lt;br /&gt;
*'''T3: extramural growth'''&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* Stranding into the mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* The mesorectal fascia (MRF) is 'involved' if the distance between MRF and tumour is ≤1 mm&lt;br /&gt;
* Stranding into the MRF = MRF is involved&lt;br /&gt;
* Involvement of MRF = T3&lt;br /&gt;
* Tumour invasion above the level of the peritoneal reflection (at the anterior side) should be considered at risk for peritoneal rather than MRF invasion&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&lt;br /&gt;
** below (MRF invasion)&lt;br /&gt;
** above&lt;br /&gt;
&lt;br /&gt;
The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment [20]. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&lt;br /&gt;
* EMVI is an important prognostic staging factor&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
* On T2-weighted MRI, a normalised, two-layered wall after CRT is suggestive of a complete response&lt;br /&gt;
* On T2-weighted MRI, a completely hypointense (fibrotic) residue without an isointense mass indicates a complete or near-complete response&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
Restaging after long course neoadjuvant treatment + downstaging interval&lt;br /&gt;
&lt;br /&gt;
* Benign nodes: Short axis diameter &amp;lt;5 mm &lt;br /&gt;
* Malign nodes: Short axis diameter ≥5 mm&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== N staging ==&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
== N restaging ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3596</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3596"/>
		<updated>2019-07-15T20:08:02Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
This article is a summary of the ''Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) to Magnetic resonance imaging for clinical management of rectal cancer''.&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Should use an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
* Use of spasmolytics may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory)&lt;br /&gt;
* Use of endorectal filling is not routinely advised (no consensus: 71 % not recommended)&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
&lt;br /&gt;
'''Sequences'''&lt;br /&gt;
* A routine protocol should (at least) include:&lt;br /&gt;
** 2D T2W sequences in 3 planes&lt;br /&gt;
** DWI sequence (at least a high b-value of ≥800)&lt;br /&gt;
* DWI images (including ADC maps) should mainly be assessed visually&lt;br /&gt;
** Quantitative ADC measurements are not routinely advised&lt;br /&gt;
* DWI is recommended for restaging of the yT-stage.&lt;br /&gt;
* FS, T1W (non-enhanced and contrast-enhanced) and DCE sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
* Coronal sequence parallel to the anal canal: should be included in distal tumours to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Patient preparation ==&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduce susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
* Morphology&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
* Tumour length&lt;br /&gt;
* T-stage&lt;br /&gt;
* Sphincter invasion&lt;br /&gt;
&lt;br /&gt;
==== Tumour length ====&lt;br /&gt;
Although the panel agreed unanimously that ‘some measure of tumour size’&lt;br /&gt;
should be reported, there was no clear consensus on a specific metric, i.e. whether this should be one-dimensional, threedimensional or a volume measurement, and if and how after CRT an estimation of the tumour volume reduction should be provided. There is no solid evidence that favours one over&lt;br /&gt;
another, although some authors have suggested that, specifically for assessment of chemoradiotherapeutic response, whole volume measurements may be preferable [23]. The panel acknowledges that several options exist but from a practical point of view decided to include tumour length as the main metric in the structured report template in Fig. 1, as this was deemed to be most commonly used and more practically applicable than other metrics, with good reported measurement reproducibility [20, 23, 24].&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
** Good prognosis&lt;br /&gt;
** Rectal wall has an intact black line (outer muscle) surrounding the tumor&lt;br /&gt;
*'''T3: extramural growth'''&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* Stranding into the mesorectal fat = equivocal sign; may indicate either a T2 or T3 tumour&lt;br /&gt;
* The mesorectal fascia (MRF) is 'involved' if the distance between MRF and tumour is ≤1 mm&lt;br /&gt;
* Stranding into the MRF = MRF is involved&lt;br /&gt;
* Involvement of MRF = T3&lt;br /&gt;
* Tumour invasion above the level of the peritoneal reflection (at the anterior side) should be considered at risk for peritoneal rather than MRF invasion&lt;br /&gt;
* Invasion of the pelvic floor or pelvic side wall muscles = T4&lt;br /&gt;
* Growth into the internal anal sphincter muscle = T3&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This information is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
* Shortest distance betwenn tumour and MRF&lt;br /&gt;
** Free (&amp;gt;2 mm)&lt;br /&gt;
** Threatened/involved (≤2 mm)&lt;br /&gt;
&lt;br /&gt;
*Location of the shortest distance between tumour and MRF&lt;br /&gt;
&lt;br /&gt;
* Tumour location in relation to anterior peritoneal reflection&lt;br /&gt;
** below (MRF invasion)&lt;br /&gt;
** above&lt;br /&gt;
&lt;br /&gt;
The anterior peritoneal reflection is a landmark that is usually recognised easily on MRI and separates the intra- and extra-peritoneal portions of the mesorectal compartment [20]. Above the anterior peritoneal reflection, the mesorectal compartment is no longer enveloped by the mesorectal fascia on its anterior aspect. As such, anterior mesorectal fascia involvement should only be reported when below the level of the anterior peritoneal reflection.&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion (EMVI) ===&lt;br /&gt;
* Assessment of extramural vascular (or venous) invasion (EMVI) should be reported routinely, both for primary staging as well as for restaging after CRT.&lt;br /&gt;
* EMVI is an important prognostic staging factor&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
* On T2-weighted MRI, a normalised, two-layered wall after CRT is suggestive of a complete response&lt;br /&gt;
* On T2-weighted MRI, a completely hypointense (fibrotic) residue without an isointense mass indicates a complete or near-complete response&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
* For nodal restaging the criteria described in Table 4 are recommended&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== N staging ==&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
== N restaging ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3595</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3595"/>
		<updated>2019-07-15T17:42:33Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Patient preparation */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Should use an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
* (Use of spasmolytics may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory))&lt;br /&gt;
* (Use of endorectal filling is not routinely advised (no consensus: 71 % not recommended))&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
* A routine protocol should (at least) include 2D T2-weighted sequences in 3 planes and a diffusion-weighted sequence (including at least a high b-value of ≥ 800)&lt;br /&gt;
* Diffusion-weighted images (including Apparent Diffusien Coefficient maps) should mainly be assessed visually; quantitative ADC measurements are not routinely advised&lt;br /&gt;
* Diffusion-weighted imaging is recommended for restaging of the yT-stage.&lt;br /&gt;
* Fatsuppressed, T1-weighted (non-enhanced and contrast-enhanced) and dynamic contrast enhanced (DCE) sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
* Coronal sequence parallel to the anal canal: should be included in distal tumours to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Patient preparation ==&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional)'''&lt;br /&gt;
* '''~60 ml of gel''' (higher volumes compress perirectal tissues significantly)&lt;br /&gt;
* Reduce susceptibility artefacts related to luminal gas on DWI.&lt;br /&gt;
* Should not be used routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
* Morphology&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
* Tumour length&lt;br /&gt;
* T-stage&lt;br /&gt;
* Sphincter invasion&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
** Good prognosis&lt;br /&gt;
** Rectal wall has an intact black line (outer muscle) surrounding the tumor&lt;br /&gt;
*'''T3: extramural growth'''&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* Stranding into the mesorectal fat is an equivocal sign that may indicate either a T2 or T3 tumour&lt;br /&gt;
* The mesorectal fascia (MRF) is 'involved' if the distance between MRF and tumour is ≤1 mm&lt;br /&gt;
* When a tumour shows stranding into the MRF, the MRF should be considered involved&lt;br /&gt;
* A tumour that involves the MRF should be considered a T3 (and not a T4) tumour&lt;br /&gt;
* Tumour invasion above the level of the peritoneal reflection (at the anterior side) should be considered at risk for peritoneal rather than MRF invasion&lt;br /&gt;
* A tumour that invades the pelvic floor or pelvic side wall muscles should be considered a T4 tumour&lt;br /&gt;
* A tumour that grows into the internal anal sphincter muscle should be considered a T3 (and not a T4) tumour&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This ifformation is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
* On T2-weighted MRI, a normalised, two-layered wall after CRT is suggestive of a complete response&lt;br /&gt;
* On T2-weighted MRI, a completely hypointense (fibrotic) residue without an isointense mass indicates a complete or near-complete response&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvment ===&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
* For nodal restaging the criteria described in Table 4 are recommended&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== N staging ==&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
== N restaging ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3594</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3594"/>
		<updated>2019-07-15T17:27:42Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
== MR image acquisition ==&lt;br /&gt;
&lt;br /&gt;
=== Hardware ===&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
* Should use an external surface coil&lt;br /&gt;
* 1.5T or 3.0T&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Patient preparation ===&lt;br /&gt;
* Use of an enema is not routinely recommended&lt;br /&gt;
* (Use of spasmolytics may be useful to reduce bowel movement artefacts (no consensus: 57 % recommended/mandatory))&lt;br /&gt;
* (Use of endorectal filling is not routinely advised (no consensus: 71 % not recommended))&lt;br /&gt;
&lt;br /&gt;
=== Sequences and sequence angulation ===&lt;br /&gt;
* A routine protocol should (at least) include 2D T2-weighted sequences in 3 planes and a diffusion-weighted sequence (including at least a high b-value of ≥ 800)&lt;br /&gt;
* Diffusion-weighted images (including Apparent Diffusien Coefficient maps) should mainly be assessed visually; quantitative ADC measurements are not routinely advised&lt;br /&gt;
* Diffusion-weighted imaging is recommended for restaging of the yT-stage.&lt;br /&gt;
* Fatsuppressed, T1-weighted (non-enhanced and contrast-enhanced) and dynamic contrast enhanced (DCE) sequences are not routinely recommended&lt;br /&gt;
* Slice thickness ≤3 mm (axial and coronal T2W) &lt;br /&gt;
&lt;br /&gt;
'''Sequence angulation'''&lt;br /&gt;
* Transverse sequences: perpedicular to the rectal tumour axis&lt;br /&gt;
* Coronal sequences: parallel to the rectal tumour axis&lt;br /&gt;
* Coronal sequence parallel to the anal canal: should be included in distal tumours to assess the relation between tumour and anal sphincter&lt;br /&gt;
&lt;br /&gt;
== Patient preparation ==&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional) (~60 ml of gel)'''&lt;br /&gt;
* When used, some experts suggest using a volume of only ~60 ml of gel, since higher volumes will compress perirectal tissues significantly&lt;br /&gt;
* Useful to reduce susceptibility artefacts related to luminal gas during diffusion-weighted MRI.&lt;br /&gt;
* Its use is not reccomended routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
== Structured reporting ==&lt;br /&gt;
Structured reporting is recommended and should include the items described in the report template of ESGAR.&lt;br /&gt;
&lt;br /&gt;
== Primary staging ==&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
* Morphology&lt;br /&gt;
* Distance from the anorectal junction to the lower pole of the tumour&lt;br /&gt;
* Tumour length&lt;br /&gt;
* T-stage&lt;br /&gt;
* Sphincter invasion&lt;br /&gt;
&lt;br /&gt;
==== T-stage ====&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
** Good prognosis&lt;br /&gt;
** Rectal wall has an intact black line (outer muscle) surrounding the tumor&lt;br /&gt;
*'''T3: extramural growth'''&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
&lt;br /&gt;
Observations:&lt;br /&gt;
* Stranding into the mesorectal fat is an equivocal sign that may indicate either a T2 or T3 tumour&lt;br /&gt;
* The mesorectal fascia (MRF) is 'involved' if the distance between MRF and tumour is ≤1 mm&lt;br /&gt;
* When a tumour shows stranding into the MRF, the MRF should be considered involved&lt;br /&gt;
* A tumour that involves the MRF should be considered a T3 (and not a T4) tumour&lt;br /&gt;
* Tumour invasion above the level of the peritoneal reflection (at the anterior side) should be considered at risk for peritoneal rather than MRF invasion&lt;br /&gt;
* A tumour that invades the pelvic floor or pelvic side wall muscles should be considered a T4 tumour&lt;br /&gt;
* A tumour that grows into the internal anal sphincter muscle should be considered a T3 (and not a T4) tumour&lt;br /&gt;
&lt;br /&gt;
==== Sphincter invasion ====&lt;br /&gt;
This ifformation is relevant to surgical approach&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvement ===&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
== Restaging after neoadjuvant treatment ==&lt;br /&gt;
* Structured reporting is recommended&lt;br /&gt;
* When considering organ preservation (watchful waiting) after CRT, MRI findings should be correlated with clinical examination (endoscopy / digital rectal examination)&lt;br /&gt;
&lt;br /&gt;
=== Local tumour status ===&lt;br /&gt;
* On T2-weighted MRI, a normalised, two-layered wall after CRT is suggestive of a complete response&lt;br /&gt;
* On T2-weighted MRI, a completely hypointense (fibrotic) residue without an isointense mass indicates a complete or near-complete response&lt;br /&gt;
&lt;br /&gt;
=== Mesorectal fascia (and peritoneal) involvment ===&lt;br /&gt;
* If a fatpad re-appears between the tumour and MRF after CRT, the MRF should be considered uninvolved/cleared.&lt;br /&gt;
* Persistent stranding of tumour into the MRF should be considered an equivocal sign that may or may not indicate persistent MRF involvement&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Lymph nodes and tumour deposits ===&lt;br /&gt;
* For nodal restaging the criteria described in Table 4 are recommended&lt;br /&gt;
&lt;br /&gt;
=== Extramural vascular invasion ===&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== N staging ==&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
== N restaging ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Downloads ==&lt;br /&gt;
* [https://link.springer.com/content/pdf/10.1007%2Fs00330-017-5026-2.pdf] Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3593</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3593"/>
		<updated>2019-07-15T16:36:45Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
== Choice of modality ==&lt;br /&gt;
&lt;br /&gt;
'''MRI (first choice)'''&lt;br /&gt;
* Mandatory for both primary staging and restaging of rectal cancer.&lt;br /&gt;
&lt;br /&gt;
'''Endorectal ultrasound (EUS)'''&lt;br /&gt;
* Staging for early tumours considered for local excision&lt;br /&gt;
* Superior diagnostic performance for differentiating T1 from T2 tumors.&lt;br /&gt;
&lt;br /&gt;
== Patient preparation ==&lt;br /&gt;
'''Spasmolytics (optional)'''&lt;br /&gt;
* Can be benefical for upper rectal tumors and when imaging is performed at 3.0T (bowel movement artifacts are most prevalent)&lt;br /&gt;
&lt;br /&gt;
'''Endorectal filling (optional) (~60 ml of gel)'''&lt;br /&gt;
* When used, some experts suggest using a volume of only ~60 ml of gel, since higher volumes will compress perirectal tissues significantly&lt;br /&gt;
* Useful to reduce susceptibility artefacts related to luminal gas during diffusion-weighted MRI.&lt;br /&gt;
* Its use is not reccomended routinely: rectal wall distension may interfere with interpretation of the distance between the tumour and the mesorectal fascia, and high T2 signal of the gel may cause T2 shine through effects on DWI.&lt;br /&gt;
&lt;br /&gt;
== T staging ==&lt;br /&gt;
&lt;br /&gt;
'''Clinical T staging'''&lt;br /&gt;
*T1: Limited to submucosa&lt;br /&gt;
*T2: Invading muscularis propria&lt;br /&gt;
*T3: Invading pericolorectal tissues (mesorectal fat)&lt;br /&gt;
*T4: Invading visceral peritoneum or other organs/structures&lt;br /&gt;
**T4a: Penetrates to the surface of visceral peritoneum&lt;br /&gt;
**T4b: Directly invades or is adherent to other organs/structures&lt;br /&gt;
&lt;br /&gt;
== MRI T staging ==&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
** Good prognosis&lt;br /&gt;
** Rectal wall has an intact black line (outer muscle) surrounding the tumor&lt;br /&gt;
*'''T3: extramural growth'''&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
&lt;br /&gt;
=== Information relevant to surgical approach ===&lt;br /&gt;
For low tumours with sphincter invasion, describe:&lt;br /&gt;
&lt;br /&gt;
Depth of invasion&lt;br /&gt;
* invades only the internal sphincter muscle&lt;br /&gt;
* also involves the intersphincteric plane&lt;br /&gt;
* also involves the external sphincter&lt;br /&gt;
&lt;br /&gt;
Height of invasion&lt;br /&gt;
* involves only the proximal 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the middle 1/3 of the complex/anal canal&lt;br /&gt;
* also involves the lower 1/3 of the complex/anal canal&lt;br /&gt;
* involves pelvic floor (levator)&lt;br /&gt;
&lt;br /&gt;
== N staging ==&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
== N restaging ==&lt;br /&gt;
&lt;br /&gt;
== MRI protocol ==&lt;br /&gt;
* High resolution&lt;br /&gt;
* Contrast medium is optional&lt;br /&gt;
* Coronal images parallel to anal canal&lt;br /&gt;
* Slice thickness ≤ 3 mm&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3560</id>
		<title>MRI of rectal cancer</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_rectal_cancer&amp;diff=3560"/>
		<updated>2019-07-14T16:06:29Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Created page with &amp;quot;{{Top |author1=Rodrigo Horstmann Castilhos |author2= }}  == T staging ==  '''Clinical T staging''' *T1: Limited to submucosa *T2: Invading muscularis prop...&amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
== T staging ==&lt;br /&gt;
&lt;br /&gt;
'''Clinical T staging'''&lt;br /&gt;
*T1: Limited to submucosa&lt;br /&gt;
*T2: Invading muscularis propria&lt;br /&gt;
*T3: Invading pericolorectal tissues (mesorectal fat)&lt;br /&gt;
*T4: Invading visceral peritoneum or other organs/structures&lt;br /&gt;
**T4a: Penetrates to the surface of visceral peritoneum&lt;br /&gt;
**T4b: Directly invades or is adherent to other organs/structures&lt;br /&gt;
&lt;br /&gt;
'''MRI T staging'''&lt;br /&gt;
* MRI doesn't differentiate T1 from T2&lt;br /&gt;
*'''T1-T2: limited to intestinal wall'''&lt;br /&gt;
** Good prognosis&lt;br /&gt;
** Rectal wall has an intact black line (outer muscle) surrounding the tumor&lt;br /&gt;
*'''T3: extramural growth'''&lt;br /&gt;
** '''T3a or T3b: ≤5 mm extramural growth'''&lt;br /&gt;
** '''T3c or T3d: &amp;gt;5 mm extramural growth'''&lt;br /&gt;
* '''T4'''&lt;br /&gt;
&lt;br /&gt;
== N staging ==&lt;br /&gt;
* Important risk factor for local recurrence&lt;br /&gt;
&lt;br /&gt;
'''Morphologically suspicious characteristics'''&lt;br /&gt;
* Round shape&lt;br /&gt;
* Irregular border&lt;br /&gt;
* Heterogeneous signal&lt;br /&gt;
&lt;br /&gt;
'''Malignant node criteria'''&lt;br /&gt;
* Short axis diameter ≥9 mm&lt;br /&gt;
* Short axis diameter 5-8 mm + ≥ 2 morphologically suspicious characteristics&lt;br /&gt;
* Short axis diameter &amp;lt;5 mm + 3 morphologically suspicious characteristics&lt;br /&gt;
* Mucinous lymph node (of any size)&lt;br /&gt;
&lt;br /&gt;
== N restaging ==&lt;br /&gt;
&lt;br /&gt;
== MRI protocol ==&lt;br /&gt;
* High resolution&lt;br /&gt;
* Contrast medium is optional&lt;br /&gt;
* Coronal images parallel to anal canal&lt;br /&gt;
* Slice thickness ≤ 3 mm&lt;br /&gt;
&lt;br /&gt;
== Treatment ==&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
Beets-Tan RGH, Lambregts DMJ, Maas M, et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting [published correction appears in Eur Radiol. 2018 Jan 10;:]. Eur Radiol. 2018;28(4):1465–1475. doi:10.1007/s00330-017-5026-2&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Main&amp;diff=3545</id>
		<title>Main</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Main&amp;diff=3545"/>
		<updated>2019-07-13T14:37:16Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&amp;lt;!--        BANNER ACROSS TOP OF PAGE         --&amp;gt;__NOTOC__&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-topbanner&amp;quot; style=&amp;quot;clear:both; position:relative; box-sizing:border-box; width:100%; margin:1.2em 0 6px; min-width:20em; border:1px solid #ddd; background-color:#f9f9f9; color:#000;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;!--        &amp;quot;WELCOME TO RADLINES&amp;quot;        --&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;margin:0.4em; text-align:center;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;font-size:162%; padding:.1em;&amp;quot;&amp;gt;Welcome to [[Radlines:About|Radlines]], open access guidelines for radiologists.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
{| role=&amp;quot;presentation&amp;quot; id=&amp;quot;mp-upper&amp;quot; style=&amp;quot;width: 100%; margin-top:4px; border-spacing: 0px;&amp;quot;&lt;br /&gt;
&amp;lt;!--        MENU IMAGE        --&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-left&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;width:339px; border:1px solid #cef2e0; padding:0; background:#f5fffa; vertical-align:top; color:#000;&amp;quot; |&lt;br /&gt;
&amp;lt;imagemap&amp;gt;&lt;br /&gt;
File:Anatomy_image_for_main_menu.png|&lt;br /&gt;
rect 0 23 82 126 [[Projectional radiography]]&lt;br /&gt;
rect 87 23 136 126 [[CT]]&lt;br /&gt;
rect 0 129 80 198 [[Ultrasonography]]&lt;br /&gt;
rect 85 126 141 198 [[MRI]]&lt;br /&gt;
rect 0 198 90 260 [[Fluoroscopy]]&lt;br /&gt;
rect 175 51 219 121 [[CT of the head]]&lt;br /&gt;
rect 234 54 278 121 [[MRI of the head]]&lt;br /&gt;
rect 149 8 329 159 [[Head]]&lt;br /&gt;
rect 170 180 232 221 [[CT of the neck]]&lt;br /&gt;
rect 237 180 311 221 [[X-ray of the cervical spine]]&lt;br /&gt;
rect 162 224 265 270 [[Thyroid]]&lt;br /&gt;
rect 147 162 332 273 [[Neck]]&lt;br /&gt;
rect 28 296 82 365 [[X-ray of the shoulder]]&lt;br /&gt;
rect 28 270 131 370 [[Shoulder]]&lt;br /&gt;
rect 21 373 126 489 [[Upper arm]]&lt;br /&gt;
rect 21 515 72 574 [[X-ray of the elbow]]&lt;br /&gt;
rect 18 491 123 579 [[Elbow]]&lt;br /&gt;
rect 3 579 111 635 [[Forearm]]&lt;br /&gt;
rect 5 659 59 725 [[X-ray of the wrist]]&lt;br /&gt;
rect 3 635 69 733 [[Wrist]]&lt;br /&gt;
rect 10 759 59 823 [[X-ray of the hand]]&lt;br /&gt;
rect 3 736 67 875 [[Hand]]&lt;br /&gt;
rect 139 293 196 365 [[X-ray of the thorax]]&lt;br /&gt;
rect 206 293 257 363 [[CT of the thorax]]&lt;br /&gt;
rect 136 373 203 424 [[Breast]]&lt;br /&gt;
rect 211 394 275 419 [[Heart]]&lt;br /&gt;
rect 206 368 306 422 [[Vascular]]&lt;br /&gt;
rect 131 270 329 427 [[Thorax]]&lt;br /&gt;
rect 141 453 203 491 [[Adrenal glands]]&lt;br /&gt;
rect 201 450 255 491 [[Liver]]&lt;br /&gt;
rect 257 453 324 491 [[Spleen]]&lt;br /&gt;
rect 144 494 239 522 [[Biliary tract]]&lt;br /&gt;
rect 237 491 322 522 [[Pancreas]]&lt;br /&gt;
rect 147 530 201 574 [[Kidney]]&lt;br /&gt;
rect 208 520 247 581 [[Aorta]]&lt;br /&gt;
rect 208 581 278 633 [[Vertebral column]]&lt;br /&gt;
rect 206 520 322 666 [[Stomach and intestines]]&lt;br /&gt;
rect 123 641 178 684 [[Pelvic bones]]&lt;br /&gt;
rect 144 522 208 612 [[Urinary system]]&lt;br /&gt;
rect 193 610 257 692 [[Urinary system]]&lt;br /&gt;
rect 111 692 172 751 [[Hip joint]]&lt;br /&gt;
rect 193 733 247 777 [[Female reproductive system]]&lt;br /&gt;
rect 252 731 304 777 [[Male reproductive system]]&lt;br /&gt;
rect 185 666 316 782 [[Reproductive system]]&lt;br /&gt;
rect 75 756 134 841 [[X-ray of the hip]]&lt;br /&gt;
rect 72 641 178 846 [[Hip]]&lt;br /&gt;
rect 123 427 332 790 [[Abdomen and pelvis]]&lt;br /&gt;
rect 72 846 232 1011 [[Thigh]]&lt;br /&gt;
rect 214 1016 270 1104 [[X-ray of the knee]]&lt;br /&gt;
rect 105 1014 278 1147 [[Knee]]&lt;br /&gt;
rect 103 1147 278 1397 [[Lower leg]]&lt;br /&gt;
rect 216 1399 270 1471 [[X-ray of the ankle]]&lt;br /&gt;
rect 105 1394 278 1474 [[Ankle]]&lt;br /&gt;
rect 193 1479 275 1533 [[X-ray of the foot]]&lt;br /&gt;
rect 105 1474 280 1538 [[Foot]]&lt;br /&gt;
rect 10 1024 82 1124 [[Vascular]]&lt;br /&gt;
rect 13 1132 82 1245 [[Musculoskeletal]]&lt;br /&gt;
rect 10 1371 90 1482 [[Contrast medium reaction]]&lt;br /&gt;
rect 3 1266 98 1487 [[Contrast media]]&lt;br /&gt;
desc bottom-left&lt;br /&gt;
&amp;lt;/imagemap&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-right&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;border:1px solid #cedff2; padding:0; background:#f5faff; vertical-align:top;&amp;quot;|&lt;br /&gt;
&amp;lt;!--        EMERGENCIES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Emergencies&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
*[[Trauma]]&lt;br /&gt;
*[[Stroke]]&lt;br /&gt;
*[[Contrast medium reaction]]&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABOUT        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Radlines:About|About Radlines]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
Radlines is an international, collaborative, non-profit, ad-free and open access encyclopedia in radiology. It is created by doctors, providing quick access to the most relevant information.&lt;br /&gt;
&amp;lt;br&amp;gt;Further information: [[Radlines:About]]&lt;br /&gt;
&amp;lt;div id=&amp;quot;articlecount&amp;quot; style=&amp;quot;font-size:85%;&amp;quot;&amp;gt;[[Special:Statistics|{{NUMBEROFARTICLES}}]] articles.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        CASE OF THE MONTH        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Case of the month&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-otd&amp;quot; style=&amp;quot;padding:0.1em 0.6em 0.5em;&amp;quot;&amp;gt;[[File:Volume rendered CT scan of a pregnancy of 37 weeks of gestational age (thumbnail).gif|left]]&lt;br /&gt;
&amp;lt;br clear=&amp;quot;all&amp;quot;&amp;gt;Volume rendering of a [[CT scan]] of a pregnancy.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABDOMEN AND PELVIS        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Abdomen and pelvis]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
*Modalities: [[CT of the abdomen and pelvis|CT]], [[MRI of the abdomen and pelvis|MRI]], [[Ultrasonography of the abdomen and pelvis|US]], [[X-ray of the abdomen and pelvis|XR]]&lt;br /&gt;
*Systems: [[Digestive system|Digestive]], [[Urinary system|Urinary]] ([[CT of the urinary system|CT]], [[Ultrasonography of the urinary system|US]]), [[Reproductive system|Reproductive]] ([[Male reproductive system|Male]], [[Female reproductive system|Female]])&lt;br /&gt;
*Organs/Regions&lt;br /&gt;
** [[Abdominal wall]] ([[Ultrasonography of the abdominal wall|US]]): [[Abdominal wall hernia|Hernia]] ([[Inguinal hernia|Inguinall]])&lt;br /&gt;
** [[Aorta]] ([[CT of the aorta|CT]]): [[Aortic dissection|Dissection]]&lt;br /&gt;
** [[Adrenal glands]]: [[CT of adrenal incidentalomas|Incidentaloma]]&lt;br /&gt;
** [[Liver]] ([[CT of the liver|CT]], [[MRI of the liver|MRI]], [[Ultrasonography of the liver|US]]): [[Cirrhosis]], [[Steatosis]], [[Liver tumor|Tumor]]&lt;br /&gt;
** [[Gallbladder]], [[Biliary tract]]: [[Ultrasonography of gallstones|Gallstones]], [[Ultrasonography of cholecystitis|Cholecystitis]]&lt;br /&gt;
** [[Kidney]]: [[Hydronephrosis]], [[Kidney stone disease|Stone]], [[Nephrostomy]]&lt;br /&gt;
** [[Ovary]]:&lt;br /&gt;
** [[Pancreas]]: [[Adenocarcinoma]], [[Pancreatic cystic lesion|Cystic lesion]], [[Pancreatitis]]&lt;br /&gt;
** [[Prostate]] ([[MRI of the prostate|MRI]], [[Ultrasonography of the prostate|US]]): [[Prostate cancer|Cancer]], [[Prostatitis]]&lt;br /&gt;
** [[Scrotum]] ([[Scrotal ultrasonography|US]])&lt;br /&gt;
** [[Spleen]] ([[Ultrasonography of the spleen|US]])&lt;br /&gt;
** [[Stomach and intestines]]: [[Appendicitis]], [[Abdominal X-ray in constipation in children|Constipation]], [[MRI of perianal fistula|Perianal fistula]], [[MRI of rectal cancer|Rectal cancer]]&lt;br /&gt;
** [[Urethra]]: [[Urethral diverticulum|Diverticulum]]&lt;br /&gt;
** [[Urinary bladder]]: &lt;br /&gt;
** [[Uterus]]: [[Adenomyosis]], [[Endometriosis]], [[Endometrial carcinoma]], [[Intrauterine devices|IUDs]], [[Leiomyoma]]&lt;br /&gt;
*Types&lt;br /&gt;
**[[Abdominal emergency|Emergency]]&lt;br /&gt;
**[[Abdominal neoplasia|Neoplasia]]&lt;br /&gt;
**[[Abdominal trauma|Trauma]] ([[CT of the abdomen and pelvis in trauma|CT]])&lt;br /&gt;
&lt;br /&gt;
&amp;lt;!-- {{Abdomen and pelvis locations}} --&amp;gt;&lt;br /&gt;
&amp;lt;!--        LOCATION UNSPECIFIC DISEASES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Location-unspecific diseases&amp;lt;/h2&amp;gt;&lt;br /&gt;
*[[Cancer]]&lt;br /&gt;
{{Superficial soft tissue diseases}}&lt;br /&gt;
|}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Cirrhosis&amp;diff=3544</id>
		<title>Cirrhosis</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Cirrhosis&amp;diff=3544"/>
		<updated>2019-07-13T14:19:02Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Created page with &amp;quot;See also: *CT of cirrhosis *Ultrasonography of cirrhosis&amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;See also:&lt;br /&gt;
*[[CT of cirrhosis]]&lt;br /&gt;
*[[Ultrasonography of cirrhosis]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Superior_mesenteric_artery_syndrome&amp;diff=3543</id>
		<title>Superior mesenteric artery syndrome</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Superior_mesenteric_artery_syndrome&amp;diff=3543"/>
		<updated>2019-07-12T23:51:41Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Created page with &amp;quot;{{Top |author1=Rodrigo Horstmann Castilhos |author2= }}  Also known as Wilkie's syndrome, this condition occurs when the third part of the duodenum is com...&amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
Also known as Wilkie's syndrome, this condition occurs when the third part of the duodenum is compressed between the superior mesenteric artery and the aorta. Under normal conditions, there is retroperitoneal fat around the third part of the duodenum, which avoids compression by creating an aortomesenteric angle &amp;gt; 28º. &lt;br /&gt;
&lt;br /&gt;
== Epidemiology ==&lt;br /&gt;
* Females (10-39 years old)&lt;br /&gt;
&lt;br /&gt;
'''Risk factors:'''&lt;br /&gt;
* Previous accentuated weight loss&lt;br /&gt;
* Previous surgery for scoliosis&lt;br /&gt;
* Anatomical variations in the ligament of Treitz, with consequent elevation of the duodenum&lt;br /&gt;
&lt;br /&gt;
== Signs and symptoms ==&lt;br /&gt;
* Postprandial upper abdominal pain that is relieved in ventral or left lateral decubitus&lt;br /&gt;
* Nausea&lt;br /&gt;
* Emesis&lt;br /&gt;
* Eeight loss&lt;br /&gt;
&lt;br /&gt;
== Diagnosis ==&lt;br /&gt;
* Symptoms of duodenal obstruction associated with:&lt;br /&gt;
** Aortomesenteric angle &amp;lt;25º&lt;br /&gt;
** Aortomesenteric distance &amp;lt;8 mm&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
CARDARELLI-LEITE, Leandro et al. Abdominal vascular syndromes: characteristic imaging findings. Radiol Bras [online]. 2016, vol.49, n.4 [cited  2019-07-12], pp.257-263. Available from: &amp;lt;http://www.scielo.br/scielo.php?script=sci_arttext&amp;amp;pid=S0100-39842016000400011&amp;amp;lng=en&amp;amp;nrm=iso&amp;gt;. ISSN 0100-3984.  http://dx.doi.org/10.1590/0100-3984.2015.0136.&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_perianal_fistula&amp;diff=3542</id>
		<title>MRI of perianal fistula</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_perianal_fistula&amp;diff=3542"/>
		<updated>2019-07-12T23:40:37Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
== Epidemiology ==&lt;br /&gt;
*Uncommon condition&lt;br /&gt;
*High morbitidy&lt;br /&gt;
*Men (2:1)&lt;br /&gt;
*Young adults&lt;br /&gt;
&lt;br /&gt;
== Technique ==&lt;br /&gt;
*Edema sequences: STIR, T2 FS&lt;br /&gt;
*Enhancement sequence: T1 FS&lt;br /&gt;
&lt;br /&gt;
== Anatomy ==&lt;br /&gt;
&lt;br /&gt;
== Classification ==&lt;br /&gt;
&lt;br /&gt;
St. Jame's classification&lt;br /&gt;
* Type 1: simple linear intersphincteric fistula&lt;br /&gt;
* Type 2: intersphincteric fistula with abscess or secondary tract&lt;br /&gt;
* Type 3: trans-sphincteric fistula&lt;br /&gt;
* Type 4: trans-sphincteric fistula with formation of abscess or secondary tract within the ischioanal fossa&lt;br /&gt;
* Type 5: suprasphincteric or extrasphincteric fistula&lt;br /&gt;
&lt;br /&gt;
== Complexity== &lt;br /&gt;
&lt;br /&gt;
*Simple&lt;br /&gt;
*Complex&lt;br /&gt;
&lt;br /&gt;
== Characteristics ==&lt;br /&gt;
* Internal opening: location (clock), high vs low.&lt;br /&gt;
* External opening: location (clock), location (perineum, natal cleft), distance to anal margin&lt;br /&gt;
* Involvement of other structures&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=User_talk:Mikael_H%C3%A4ggstr%C3%B6m&amp;diff=3541</id>
		<title>User talk:Mikael Häggström</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=User_talk:Mikael_H%C3%A4ggstr%C3%B6m&amp;diff=3541"/>
		<updated>2019-07-12T23:09:44Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Some errors */ new section&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;==Task: Copying children’s X-ray pictures==&lt;br /&gt;
The task here is to copy X-ray images of children of various ages from bonepit.com (http://bonepit.com/Normal%20for%20age/Normal%20for%20age%20index.htm) to the corresponding articles in [https://radlines.org/Main radlines.org]:&lt;br /&gt;
&lt;br /&gt;
*Hand: https://radlines.org/Normal_X-rays_of_the_hand_at_0_to_20_years (currently takes some time to load)&lt;br /&gt;
*Wrist: https://radlines.org/X-ray_of_the_wrist&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
*Cx spine: https://radlines.org/X-ray_of_the_cervical_spine&lt;br /&gt;
&lt;br /&gt;
*Pelvis: https://radlines.org/Normal_X-rays_of_the_pelvic_bones_at_0_to_20_years&lt;br /&gt;
&lt;br /&gt;
I've already completed the images for the thumb, &lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
1. I will provide you with login details to an account you can use to edit pages&lt;br /&gt;
&amp;lt;br&amp;gt;2. Continue with the table of the hand: https://radlines.org/Normal_X-rays_of_the_hand_at_0_to_20_years&lt;br /&gt;
:2.1. Go to http://bonepit.com/Normal%20for%20age/Normal%20for%20age%20index.htm and download images to your computer. The next one is &amp;quot;10M Hand&amp;quot; (10 year old male, hand). You may start with one image, and then go through the rest of the process with that one. When you feel familiar with the steps, you may download a dozen of images at the same time.&lt;br /&gt;
:2.2. Look at the outline of the table in Radlines, and follow the same naming convention (the next image will be named &amp;quot;File:X-ray of the hand of a 10 year old male - dorsoplantar.jpg&amp;quot;): https://radlines.org/Normal_X-rays_of_the_hand_at_0_to_20_years&lt;br /&gt;
:2.3. Go to: https://commons.wikimedia.org/wiki/Special:UploadWizard&lt;br /&gt;
:2.4. Click &amp;quot;Select media files to share&amp;quot;&lt;br /&gt;
:2.5. Select the images on your computer&lt;br /&gt;
:2.6. Click &amp;quot;Continue&amp;quot;&lt;br /&gt;
:2.7. Click &amp;quot;Next&amp;quot;&lt;br /&gt;
:2.8&lt;br /&gt;
&lt;br /&gt;
== Some errors ==&lt;br /&gt;
&lt;br /&gt;
Hi, &lt;br /&gt;
&lt;br /&gt;
I can't edit with VisualEditor. I get the following error:&lt;br /&gt;
&lt;br /&gt;
''You're not allowed to edit this wiki through the API.''&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
When I go to [[Special:Preferences]], I get:&lt;br /&gt;
&lt;br /&gt;
''Warning: array_key_exists() expects parameter 2 to be array, null given in /home/radviser/www/www/extensions/UploadWizard/UploadWizardHooks.php on line 217&lt;br /&gt;
Hilfe&lt;br /&gt;
Interner Fehler&lt;br /&gt;
[XSkSVDeiK8Qus638G@b1ZQAAAAE] /Special:Preferences InvalidArgumentException from line 260 of /home/radviser/www/www/includes/Message.php: $key must be a string or an array&lt;br /&gt;
&lt;br /&gt;
Backtrace:&lt;br /&gt;
&lt;br /&gt;
#0 /home/radviser/www/www/includes/GlobalFunctions.php(1419): Message-&amp;gt;__construct(NULL)&lt;br /&gt;
#1 /home/radviser/www/www/extensions/UploadWizard/UploadWizardHooks.php(224): wfMessage(NULL)&lt;br /&gt;
#2 /home/radviser/www/www/extensions/UploadWizard/UploadWizardHooks.php(76): UploadWizardHooks::getLicenseMessage(string, array)&lt;br /&gt;
#3 /home/radviser/www/www/includes/Hooks.php(177): UploadWizardHooks::onGetPreferences(User, array)&lt;br /&gt;
#4 /home/radviser/www/www/includes/Hooks.php(205): Hooks::callHook(string, array, array, NULL)&lt;br /&gt;
#5 /home/radviser/www/www/includes/Preferences.php(98): Hooks::run(string, array)&lt;br /&gt;
#6 /home/radviser/www/www/includes/Preferences.php(1356): Preferences::getPreferences(User, RequestContext)&lt;br /&gt;
#7 /home/radviser/www/www/includes/specials/SpecialPreferences.php(127): Preferences::getFormObject(User, RequestContext)&lt;br /&gt;
#8 /home/radviser/www/www/includes/specials/SpecialPreferences.php(84): SpecialPreferences-&amp;gt;getFormObject(User, RequestContext)&lt;br /&gt;
#9 /home/radviser/www/www/includes/specialpage/SpecialPage.php(522): SpecialPreferences-&amp;gt;execute(NULL)&lt;br /&gt;
#10 /home/radviser/www/www/includes/specialpage/SpecialPageFactory.php(578): SpecialPage-&amp;gt;run(NULL)&lt;br /&gt;
#11 /home/radviser/www/www/includes/MediaWiki.php(287): SpecialPageFactory::executePath(Title, RequestContext)&lt;br /&gt;
#12 /home/radviser/www/www/includes/MediaWiki.php(851): MediaWiki-&amp;gt;performRequest()&lt;br /&gt;
#13 /home/radviser/www/www/includes/MediaWiki.php(523): MediaWiki-&amp;gt;main()&lt;br /&gt;
#14 /home/radviser/www/www/index.php(43): MediaWiki-&amp;gt;run()&lt;br /&gt;
#15 {main}&lt;br /&gt;
''&lt;br /&gt;
&lt;br /&gt;
--[[User:Rhcastilhos|Rhcastilhos]] ([[User talk:Rhcastilhos|talk]]) 02:09, 13 July 2019 (EEST)&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_perianal_fistula&amp;diff=3540</id>
		<title>MRI of perianal fistula</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_perianal_fistula&amp;diff=3540"/>
		<updated>2019-07-12T23:04:56Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Technique ==&lt;br /&gt;
*Edema sequences: STIR, T2 FS&lt;br /&gt;
*Enhancement sequence: T1 FS&lt;br /&gt;
&lt;br /&gt;
== Types ==&lt;br /&gt;
* Intersphincteric&lt;br /&gt;
* Transsphincteric&lt;br /&gt;
* Suprasphincteric&lt;br /&gt;
* Extrasphincteric&lt;br /&gt;
&lt;br /&gt;
== Complexity== &lt;br /&gt;
&lt;br /&gt;
*Simple&lt;br /&gt;
*Complex&lt;br /&gt;
&lt;br /&gt;
== Characteristics ==&lt;br /&gt;
* Internal opening: location (clock), high vs low.&lt;br /&gt;
* External opening: location (clock), location (perineum, natal cleft), distance to anal margin&lt;br /&gt;
* Involvement of other structures&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_perianal_fistula&amp;diff=3539</id>
		<title>MRI of perianal fistula</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_perianal_fistula&amp;diff=3539"/>
		<updated>2019-07-12T23:03:54Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Created page with &amp;quot;{{Top |author1=Rodrigo Horstmann Castilhos |author2= }}   == Techinique == *Edema sequences: STIR, T2 FS *Enhancement sequence: T1 FS  == Types == * Inter...&amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
== Techinique ==&lt;br /&gt;
*Edema sequences: STIR, T2 FS&lt;br /&gt;
*Enhancement sequence: T1 FS&lt;br /&gt;
&lt;br /&gt;
== Types ==&lt;br /&gt;
* Intersphincteric&lt;br /&gt;
* Transsphincteric&lt;br /&gt;
* Suprasphincteric&lt;br /&gt;
* Extrasphincteric&lt;br /&gt;
&lt;br /&gt;
== Complexity== &lt;br /&gt;
&lt;br /&gt;
*Simple&lt;br /&gt;
*Complex&lt;br /&gt;
&lt;br /&gt;
== Characteristics ==&lt;br /&gt;
* Internal opening: location (clock), high vs low.&lt;br /&gt;
* External opening: location (clock), location (perineum, natal cleft), distance to anal margin&lt;br /&gt;
* Involvement of other structures&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&amp;lt;references /&amp;gt;&lt;br /&gt;
&lt;br /&gt;
[[Category:MRI]]&lt;br /&gt;
[[Category:Rectum]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Main&amp;diff=3538</id>
		<title>Main</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Main&amp;diff=3538"/>
		<updated>2019-07-12T21:06:18Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&amp;lt;!--        BANNER ACROSS TOP OF PAGE         --&amp;gt;__NOTOC__&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-topbanner&amp;quot; style=&amp;quot;clear:both; position:relative; box-sizing:border-box; width:100%; margin:1.2em 0 6px; min-width:20em; border:1px solid #ddd; background-color:#f9f9f9; color:#000;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;!--        &amp;quot;WELCOME TO RADLINES&amp;quot;        --&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;margin:0.4em; text-align:center;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;font-size:162%; padding:.1em;&amp;quot;&amp;gt;Welcome to [[Radlines:About|Radlines]], open access guidelines for radiologists.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
{| role=&amp;quot;presentation&amp;quot; id=&amp;quot;mp-upper&amp;quot; style=&amp;quot;width: 100%; margin-top:4px; border-spacing: 0px;&amp;quot;&lt;br /&gt;
&amp;lt;!--        MENU IMAGE        --&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-left&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;width:339px; border:1px solid #cef2e0; padding:0; background:#f5fffa; vertical-align:top; color:#000;&amp;quot; |&lt;br /&gt;
&amp;lt;imagemap&amp;gt;&lt;br /&gt;
File:Anatomy_image_for_main_menu.png|&lt;br /&gt;
rect 0 23 82 126 [[Projectional radiography]]&lt;br /&gt;
rect 87 23 136 126 [[CT]]&lt;br /&gt;
rect 0 129 80 198 [[Ultrasonography]]&lt;br /&gt;
rect 85 126 141 198 [[MRI]]&lt;br /&gt;
rect 0 198 90 260 [[Fluoroscopy]]&lt;br /&gt;
rect 175 51 219 121 [[CT of the head]]&lt;br /&gt;
rect 234 54 278 121 [[MRI of the head]]&lt;br /&gt;
rect 149 8 329 159 [[Head]]&lt;br /&gt;
rect 170 180 232 221 [[CT of the neck]]&lt;br /&gt;
rect 237 180 311 221 [[X-ray of the cervical spine]]&lt;br /&gt;
rect 162 224 265 270 [[Thyroid]]&lt;br /&gt;
rect 147 162 332 273 [[Neck]]&lt;br /&gt;
rect 28 296 82 365 [[X-ray of the shoulder]]&lt;br /&gt;
rect 28 270 131 370 [[Shoulder]]&lt;br /&gt;
rect 21 373 126 489 [[Upper arm]]&lt;br /&gt;
rect 21 515 72 574 [[X-ray of the elbow]]&lt;br /&gt;
rect 18 491 123 579 [[Elbow]]&lt;br /&gt;
rect 3 579 111 635 [[Forearm]]&lt;br /&gt;
rect 5 659 59 725 [[X-ray of the wrist]]&lt;br /&gt;
rect 3 635 69 733 [[Wrist]]&lt;br /&gt;
rect 10 759 59 823 [[X-ray of the hand]]&lt;br /&gt;
rect 3 736 67 875 [[Hand]]&lt;br /&gt;
rect 139 293 196 365 [[X-ray of the thorax]]&lt;br /&gt;
rect 206 293 257 363 [[CT of the thorax]]&lt;br /&gt;
rect 136 373 203 424 [[Breast]]&lt;br /&gt;
rect 211 394 275 419 [[Heart]]&lt;br /&gt;
rect 206 368 306 422 [[Vascular]]&lt;br /&gt;
rect 131 270 329 427 [[Thorax]]&lt;br /&gt;
rect 141 453 203 491 [[Adrenal glands]]&lt;br /&gt;
rect 201 450 255 491 [[Liver]]&lt;br /&gt;
rect 257 453 324 491 [[Spleen]]&lt;br /&gt;
rect 144 494 239 522 [[Biliary tract]]&lt;br /&gt;
rect 237 491 322 522 [[Pancreas]]&lt;br /&gt;
rect 147 530 201 574 [[Kidney]]&lt;br /&gt;
rect 208 520 247 581 [[Aorta]]&lt;br /&gt;
rect 208 581 278 633 [[Vertebral column]]&lt;br /&gt;
rect 206 520 322 666 [[Stomach and intestines]]&lt;br /&gt;
rect 123 641 178 684 [[Pelvic bones]]&lt;br /&gt;
rect 144 522 208 612 [[Urinary system]]&lt;br /&gt;
rect 193 610 257 692 [[Urinary system]]&lt;br /&gt;
rect 111 692 172 751 [[Hip joint]]&lt;br /&gt;
rect 193 733 247 777 [[Female reproductive system]]&lt;br /&gt;
rect 252 731 304 777 [[Male reproductive system]]&lt;br /&gt;
rect 185 666 316 782 [[Reproductive system]]&lt;br /&gt;
rect 75 756 134 841 [[X-ray of the hip]]&lt;br /&gt;
rect 72 641 178 846 [[Hip]]&lt;br /&gt;
rect 123 427 332 790 [[Abdomen and pelvis]]&lt;br /&gt;
rect 72 846 232 1011 [[Thigh]]&lt;br /&gt;
rect 214 1016 270 1104 [[X-ray of the knee]]&lt;br /&gt;
rect 105 1014 278 1147 [[Knee]]&lt;br /&gt;
rect 103 1147 278 1397 [[Lower leg]]&lt;br /&gt;
rect 216 1399 270 1471 [[X-ray of the ankle]]&lt;br /&gt;
rect 105 1394 278 1474 [[Ankle]]&lt;br /&gt;
rect 193 1479 275 1533 [[X-ray of the foot]]&lt;br /&gt;
rect 105 1474 280 1538 [[Foot]]&lt;br /&gt;
rect 10 1024 82 1124 [[Vascular]]&lt;br /&gt;
rect 13 1132 82 1245 [[Musculoskeletal]]&lt;br /&gt;
rect 10 1371 90 1482 [[Contrast medium reaction]]&lt;br /&gt;
rect 3 1266 98 1487 [[Contrast media]]&lt;br /&gt;
desc bottom-left&lt;br /&gt;
&amp;lt;/imagemap&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-right&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;border:1px solid #cedff2; padding:0; background:#f5faff; vertical-align:top;&amp;quot;|&lt;br /&gt;
&amp;lt;!--        EMERGENCIES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Emergencies&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
*[[Trauma]]&lt;br /&gt;
*[[Stroke]]&lt;br /&gt;
*[[Contrast medium reaction]]&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABOUT        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Radlines:About|About Radlines]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
Radlines is an international, collaborative, non-profit, ad-free and open access encyclopedia in radiology. It is created by doctors, providing quick access to the most relevant information.&lt;br /&gt;
&amp;lt;br&amp;gt;Further information: [[Radlines:About]]&lt;br /&gt;
&amp;lt;div id=&amp;quot;articlecount&amp;quot; style=&amp;quot;font-size:85%;&amp;quot;&amp;gt;[[Special:Statistics|{{NUMBEROFARTICLES}}]] articles.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        CASE OF THE MONTH        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Case of the month&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-otd&amp;quot; style=&amp;quot;padding:0.1em 0.6em 0.5em;&amp;quot;&amp;gt;[[File:Volume rendered CT scan of a pregnancy of 37 weeks of gestational age (thumbnail).gif|left]]&lt;br /&gt;
&amp;lt;br clear=&amp;quot;all&amp;quot;&amp;gt;Volume rendering of a [[CT scan]] of a pregnancy.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABDOMEN AND PELVIS        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Abdomen and pelvis]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
*Modalities: [[CT of the abdomen and pelvis|CT]], [[MRI of the abdomen and pelvis|MRI]], [[Ultrasonography of the abdomen and pelvis|US]], [[X-ray of the abdomen and pelvis|XR]]&lt;br /&gt;
*Systems: [[Digestive system|Digestive]], [[Urinary system|Urinary]] ([[CT of the urinary system|CT]], [[Ultrasonography of the urinary system|US]]), [[Reproductive system|Reproductive]] ([[Male reproductive system|Male]], [[Female reproductive system|Female]])&lt;br /&gt;
*Organs/Regions&lt;br /&gt;
** [[Abdominal wall]]: [[Abdominal wall hernia|Hernia]]&lt;br /&gt;
** [[Aorta]]: [[Aortic dissection]]&lt;br /&gt;
** [[Adrenal glands]]: [[CT of adrenal incidentalomas|Incidentaloma]]&lt;br /&gt;
** [[Liver]] ([[CT of the liver|CT]], [[MRI of the liver|MRI]], [[Ultrasonography of the liver|US]]): [[Cirrhosis]], [[Steatosis]], [[Liver tumor|Tumor]]&lt;br /&gt;
** [[Gallbladder]], [[Biliary tract]]: [[Ultrasonography of gallstones|Gallstones]], [[Ultrasonography of cholecystitis|Cholecystitis]]&lt;br /&gt;
** [[Kidney]]: [[Hydronephrosis]], [[Kidney stone disease|Stone]], [[Nephrostomy]]&lt;br /&gt;
** [[Ovary]]:&lt;br /&gt;
** [[Pancreas]]: [[Adenocarcinoma]], [[Pancreatic cystic lesion|Cystic lesion]], [[Pancreatitis]], &lt;br /&gt;
** [[Prostate]] ([[MRI of the prostate|MRI]], [[Ultrasonography of the prostate|US]]): [[Prostate cancer|Cancer]], [[Prostatitis]]&lt;br /&gt;
** [[Scrotum]] ([[Scrotal ultrasonography|US]])&lt;br /&gt;
** [[Spleen]] ([[Ultrasonography of the spleen|US]])&lt;br /&gt;
** [[Stomach and intestines]]: [[Appendicitis]], [[Abdominal X-ray in constipation in children|Constipation]], [[MRI of perianal fistula|Perianal fistula]], [[MRI of rectal cancer|Rectal cancer]]&lt;br /&gt;
** [[Urethra]]: [[Urethral diverticulum|Diverticulum]]&lt;br /&gt;
** [[Uterus]]: [[Adenomyosis]], [[Endometriosis]], [[Endometrial carcinoma]], [[Leiomyoma]]&lt;br /&gt;
&lt;br /&gt;
&amp;lt;!-- {{Abdomen and pelvis locations}} --&amp;gt;&lt;br /&gt;
&amp;lt;!--        LOCATION UNSPECIFIC DISEASES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Location-unspecific diseases&amp;lt;/h2&amp;gt;&lt;br /&gt;
*[[Cancer]]&lt;br /&gt;
{{Superficial soft tissue diseases}}&lt;br /&gt;
|}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Appendicitis&amp;diff=3537</id>
		<title>Appendicitis</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Appendicitis&amp;diff=3537"/>
		<updated>2019-07-12T20:32:53Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Created page with &amp;quot;See also: * Ultrasonography of appendicitis * CT of appendicitis&amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;See also:&lt;br /&gt;
* [[Ultrasonography of appendicitis]]&lt;br /&gt;
* [[CT of appendicitis]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Main&amp;diff=3536</id>
		<title>Main</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Main&amp;diff=3536"/>
		<updated>2019-07-12T20:32:22Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&amp;lt;!--        BANNER ACROSS TOP OF PAGE         --&amp;gt;__NOTOC__&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-topbanner&amp;quot; style=&amp;quot;clear:both; position:relative; box-sizing:border-box; width:100%; margin:1.2em 0 6px; min-width:20em; border:1px solid #ddd; background-color:#f9f9f9; color:#000;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;!--        &amp;quot;WELCOME TO RADLINES&amp;quot;        --&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;margin:0.4em; text-align:center;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;font-size:162%; padding:.1em;&amp;quot;&amp;gt;Welcome to [[Radlines:About|Radlines]], open access guidelines for radiologists.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
{| role=&amp;quot;presentation&amp;quot; id=&amp;quot;mp-upper&amp;quot; style=&amp;quot;width: 100%; margin-top:4px; border-spacing: 0px;&amp;quot;&lt;br /&gt;
&amp;lt;!--        MENU IMAGE        --&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-left&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;width:339px; border:1px solid #cef2e0; padding:0; background:#f5fffa; vertical-align:top; color:#000;&amp;quot; |&lt;br /&gt;
&amp;lt;imagemap&amp;gt;&lt;br /&gt;
File:Anatomy_image_for_main_menu.png|&lt;br /&gt;
rect 0 23 82 126 [[Projectional radiography]]&lt;br /&gt;
rect 87 23 136 126 [[CT]]&lt;br /&gt;
rect 0 129 80 198 [[Ultrasonography]]&lt;br /&gt;
rect 85 126 141 198 [[MRI]]&lt;br /&gt;
rect 0 198 90 260 [[Fluoroscopy]]&lt;br /&gt;
rect 175 51 219 121 [[CT of the head]]&lt;br /&gt;
rect 234 54 278 121 [[MRI of the head]]&lt;br /&gt;
rect 149 8 329 159 [[Head]]&lt;br /&gt;
rect 170 180 232 221 [[CT of the neck]]&lt;br /&gt;
rect 237 180 311 221 [[X-ray of the cervical spine]]&lt;br /&gt;
rect 162 224 265 270 [[Thyroid]]&lt;br /&gt;
rect 147 162 332 273 [[Neck]]&lt;br /&gt;
rect 28 296 82 365 [[X-ray of the shoulder]]&lt;br /&gt;
rect 28 270 131 370 [[Shoulder]]&lt;br /&gt;
rect 21 373 126 489 [[Upper arm]]&lt;br /&gt;
rect 21 515 72 574 [[X-ray of the elbow]]&lt;br /&gt;
rect 18 491 123 579 [[Elbow]]&lt;br /&gt;
rect 3 579 111 635 [[Forearm]]&lt;br /&gt;
rect 5 659 59 725 [[X-ray of the wrist]]&lt;br /&gt;
rect 3 635 69 733 [[Wrist]]&lt;br /&gt;
rect 10 759 59 823 [[X-ray of the hand]]&lt;br /&gt;
rect 3 736 67 875 [[Hand]]&lt;br /&gt;
rect 139 293 196 365 [[X-ray of the thorax]]&lt;br /&gt;
rect 206 293 257 363 [[CT of the thorax]]&lt;br /&gt;
rect 136 373 203 424 [[Breast]]&lt;br /&gt;
rect 211 394 275 419 [[Heart]]&lt;br /&gt;
rect 206 368 306 422 [[Vascular]]&lt;br /&gt;
rect 131 270 329 427 [[Thorax]]&lt;br /&gt;
rect 141 453 203 491 [[Adrenal glands]]&lt;br /&gt;
rect 201 450 255 491 [[Liver]]&lt;br /&gt;
rect 257 453 324 491 [[Spleen]]&lt;br /&gt;
rect 144 494 239 522 [[Biliary tract]]&lt;br /&gt;
rect 237 491 322 522 [[Pancreas]]&lt;br /&gt;
rect 147 530 201 574 [[Kidney]]&lt;br /&gt;
rect 208 520 247 581 [[Aorta]]&lt;br /&gt;
rect 208 581 278 633 [[Vertebral column]]&lt;br /&gt;
rect 206 520 322 666 [[Stomach and intestines]]&lt;br /&gt;
rect 123 641 178 684 [[Pelvic bones]]&lt;br /&gt;
rect 144 522 208 612 [[Urinary system]]&lt;br /&gt;
rect 193 610 257 692 [[Urinary system]]&lt;br /&gt;
rect 111 692 172 751 [[Hip joint]]&lt;br /&gt;
rect 193 733 247 777 [[Female reproductive system]]&lt;br /&gt;
rect 252 731 304 777 [[Male reproductive system]]&lt;br /&gt;
rect 185 666 316 782 [[Reproductive system]]&lt;br /&gt;
rect 75 756 134 841 [[X-ray of the hip]]&lt;br /&gt;
rect 72 641 178 846 [[Hip]]&lt;br /&gt;
rect 123 427 332 790 [[Abdomen and pelvis]]&lt;br /&gt;
rect 72 846 232 1011 [[Thigh]]&lt;br /&gt;
rect 214 1016 270 1104 [[X-ray of the knee]]&lt;br /&gt;
rect 105 1014 278 1147 [[Knee]]&lt;br /&gt;
rect 103 1147 278 1397 [[Lower leg]]&lt;br /&gt;
rect 216 1399 270 1471 [[X-ray of the ankle]]&lt;br /&gt;
rect 105 1394 278 1474 [[Ankle]]&lt;br /&gt;
rect 193 1479 275 1533 [[X-ray of the foot]]&lt;br /&gt;
rect 105 1474 280 1538 [[Foot]]&lt;br /&gt;
rect 10 1024 82 1124 [[Vascular]]&lt;br /&gt;
rect 13 1132 82 1245 [[Musculoskeletal]]&lt;br /&gt;
rect 10 1371 90 1482 [[Contrast medium reaction]]&lt;br /&gt;
rect 3 1266 98 1487 [[Contrast media]]&lt;br /&gt;
desc bottom-left&lt;br /&gt;
&amp;lt;/imagemap&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-right&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;border:1px solid #cedff2; padding:0; background:#f5faff; vertical-align:top;&amp;quot;|&lt;br /&gt;
&amp;lt;!--        EMERGENCIES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Emergencies&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
*[[Trauma]]&lt;br /&gt;
*[[Stroke]]&lt;br /&gt;
*[[Contrast medium reaction]]&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABOUT        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Radlines:About|About Radlines]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
Radlines is an international, collaborative, non-profit, ad-free and open access encyclopedia in radiology. It is created by doctors, providing quick access to the most relevant information.&lt;br /&gt;
&amp;lt;br&amp;gt;Further information: [[Radlines:About]]&lt;br /&gt;
&amp;lt;div id=&amp;quot;articlecount&amp;quot; style=&amp;quot;font-size:85%;&amp;quot;&amp;gt;[[Special:Statistics|{{NUMBEROFARTICLES}}]] articles.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        CASE OF THE MONTH        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Case of the month&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-otd&amp;quot; style=&amp;quot;padding:0.1em 0.6em 0.5em;&amp;quot;&amp;gt;[[File:Volume rendered CT scan of a pregnancy of 37 weeks of gestational age (thumbnail).gif|left]]&lt;br /&gt;
&amp;lt;br clear=&amp;quot;all&amp;quot;&amp;gt;Volume rendering of a [[CT scan]] of a pregnancy.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABDOMEN AND PELVIS        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Abdomen and pelvis]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
*Modalities: [[CT of the abdomen and pelvis|CT]], [[MRI of the abdomen and pelvis|MRI]], [[Ultrasonography of the abdomen and pelvis|US]], [[X-ray of the abdomen and pelvis|XR]]&lt;br /&gt;
*Systems: [[Digestive system|Digestive]], [[Urinary system|Urinary]] ([[CT of the urinary system|CT]], [[Ultrasonography of the urinary system|US]]), [[Reproductive system|Reproductive]] ([[Male reproductive system|Male]], [[Female reproductive system|Female]])&lt;br /&gt;
*Organs/Regions&lt;br /&gt;
** [[Abdominal wall]]: [[Abdominal wall hernia|Hernia]]&lt;br /&gt;
** [[Aorta]]: [[Aortic dissection]]&lt;br /&gt;
** [[Adrenal glands]]:&lt;br /&gt;
** [[Liver]] ([[CT of the liver|CT]], [[MRI of the liver|MRI]], [[Ultrasonography of the liver|US]]): [[Cirrhosis]], [[Steatosis]], [[Liver tumor|Tumor]]&lt;br /&gt;
** [[Gallbladder]], [[Biliary tract]]:&lt;br /&gt;
** [[Kidney]]: [[Hydronephrosis]], [[Kidney stone disease|Stone]], [[Nephrostomy]]&lt;br /&gt;
** [[Ovary]]:&lt;br /&gt;
** [[Pancreas]]: [[Pancreatitis]]&lt;br /&gt;
** [[Prostate]] ([[MRI of the prostate|MRI]], [[Ultrasonography of the prostate|US]])&lt;br /&gt;
** [[Scrotum]] ([[Scrotal ultrasonography|US]])&lt;br /&gt;
** [[Spleen]] ([[Ultrasonography of the spleen|US]])&lt;br /&gt;
** [[Stomach and intestines]]: [[Appendicitis]], [[MRI of perianal fistula|Perianal fistula]], [[MRI of rectal cancer|Rectal cancer]]&lt;br /&gt;
** [[Urethra]]: [[Urethral diverticulum|Diverticulum]]&lt;br /&gt;
** [[Uterus]]: [[Adenomyosis]], [[Endometriosis]], [[Endometrial carcinoma]], [[Leiomyoma]]&lt;br /&gt;
&lt;br /&gt;
&amp;lt;!-- {{Abdomen and pelvis locations}} --&amp;gt;&lt;br /&gt;
&amp;lt;!--        LOCATION UNSPECIFIC DISEASES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Location-unspecific diseases&amp;lt;/h2&amp;gt;&lt;br /&gt;
*[[Cancer]]&lt;br /&gt;
{{Superficial soft tissue diseases}}&lt;br /&gt;
|}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3535</id>
		<title>MRI of the liver</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3535"/>
		<updated>2019-07-12T20:24:02Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
[[File:MRI of Caroli disease (d).jpg|right]]&lt;br /&gt;
&lt;br /&gt;
==Technique==&lt;br /&gt;
Requires a phased array torso [[coil]].&lt;br /&gt;
&lt;br /&gt;
==Basic screening==&lt;br /&gt;
*'''Morphology''': verify size, borders and contours.&lt;br /&gt;
*'''Liver parenchyma''': Scan for steatosis, iron deposition&lt;br /&gt;
*'''Focal lesions''': Scan for nodules&lt;br /&gt;
*'''Biliary ducts''':&lt;br /&gt;
*'''Hepatic veins'''&lt;br /&gt;
*'''Portal vein'''&lt;br /&gt;
&lt;br /&gt;
'''Search for extrahepatic findings'''&lt;br /&gt;
*'''Lymph''' nodes in hepatic hilum.&lt;br /&gt;
*Signs of portal hypertension: [[ascites]], [[splenomegaly]]; portosystemic collateral vessels&lt;br /&gt;
&lt;br /&gt;
==Report==&lt;br /&gt;
&lt;br /&gt;
[[LI-RADS]] (Liver Imaging and Reporting Data System) system should be used only if patient has a high risk for hepatocellular carcinoma (cirrhosis, chronic hepatitis B or current/prior HCC).&lt;br /&gt;
&lt;br /&gt;
==Lesions and diseases==&lt;br /&gt;
*[[Fatty liver disease]]: [[Steatosis|Liver steatosis]], [[Nonalcoholic steatohepatitis|NASH]];&lt;br /&gt;
*[[Liver iron deposition]]&lt;br /&gt;
*[[Cirrhosis]]&lt;br /&gt;
*[[Autoimmune hepatitis]]&lt;br /&gt;
*[[Primary biliary cirrhosis]]&lt;br /&gt;
*[[Primary sclerosing cholangitis]]&lt;br /&gt;
*[[Hepatic hemangioma]]&lt;br /&gt;
*[[Hepatic adenoma]]&lt;br /&gt;
*[[Focal nodular hyperplasia]]&lt;br /&gt;
*[[Hepatocellular carcinoma]]&lt;br /&gt;
*[[Cholangiocarcinoma]]&lt;br /&gt;
*[[Liver metastases]]&lt;br /&gt;
*[[Budd-Chiari syndrome]]&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;br /&gt;
&lt;br /&gt;
[[Category:Liver]]&lt;br /&gt;
[[Category:MRI]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Main&amp;diff=3534</id>
		<title>Main</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Main&amp;diff=3534"/>
		<updated>2019-07-12T20:22:56Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&amp;lt;!--        BANNER ACROSS TOP OF PAGE         --&amp;gt;__NOTOC__&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-topbanner&amp;quot; style=&amp;quot;clear:both; position:relative; box-sizing:border-box; width:100%; margin:1.2em 0 6px; min-width:20em; border:1px solid #ddd; background-color:#f9f9f9; color:#000;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;!--        &amp;quot;WELCOME TO RADLINES&amp;quot;        --&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;margin:0.4em; text-align:center;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;font-size:162%; padding:.1em;&amp;quot;&amp;gt;Welcome to [[Radlines:About|Radlines]], open access guidelines for radiologists.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
{| role=&amp;quot;presentation&amp;quot; id=&amp;quot;mp-upper&amp;quot; style=&amp;quot;width: 100%; margin-top:4px; border-spacing: 0px;&amp;quot;&lt;br /&gt;
&amp;lt;!--        MENU IMAGE        --&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-left&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;width:339px; border:1px solid #cef2e0; padding:0; background:#f5fffa; vertical-align:top; color:#000;&amp;quot; |&lt;br /&gt;
&amp;lt;imagemap&amp;gt;&lt;br /&gt;
File:Anatomy_image_for_main_menu.png|&lt;br /&gt;
rect 0 23 82 126 [[Projectional radiography]]&lt;br /&gt;
rect 87 23 136 126 [[CT]]&lt;br /&gt;
rect 0 129 80 198 [[Ultrasonography]]&lt;br /&gt;
rect 85 126 141 198 [[MRI]]&lt;br /&gt;
rect 0 198 90 260 [[Fluoroscopy]]&lt;br /&gt;
rect 175 51 219 121 [[CT of the head]]&lt;br /&gt;
rect 234 54 278 121 [[MRI of the head]]&lt;br /&gt;
rect 149 8 329 159 [[Head]]&lt;br /&gt;
rect 170 180 232 221 [[CT of the neck]]&lt;br /&gt;
rect 237 180 311 221 [[X-ray of the cervical spine]]&lt;br /&gt;
rect 162 224 265 270 [[Thyroid]]&lt;br /&gt;
rect 147 162 332 273 [[Neck]]&lt;br /&gt;
rect 28 296 82 365 [[X-ray of the shoulder]]&lt;br /&gt;
rect 28 270 131 370 [[Shoulder]]&lt;br /&gt;
rect 21 373 126 489 [[Upper arm]]&lt;br /&gt;
rect 21 515 72 574 [[X-ray of the elbow]]&lt;br /&gt;
rect 18 491 123 579 [[Elbow]]&lt;br /&gt;
rect 3 579 111 635 [[Forearm]]&lt;br /&gt;
rect 5 659 59 725 [[X-ray of the wrist]]&lt;br /&gt;
rect 3 635 69 733 [[Wrist]]&lt;br /&gt;
rect 10 759 59 823 [[X-ray of the hand]]&lt;br /&gt;
rect 3 736 67 875 [[Hand]]&lt;br /&gt;
rect 139 293 196 365 [[X-ray of the thorax]]&lt;br /&gt;
rect 206 293 257 363 [[CT of the thorax]]&lt;br /&gt;
rect 136 373 203 424 [[Breast]]&lt;br /&gt;
rect 211 394 275 419 [[Heart]]&lt;br /&gt;
rect 206 368 306 422 [[Vascular]]&lt;br /&gt;
rect 131 270 329 427 [[Thorax]]&lt;br /&gt;
rect 141 453 203 491 [[Adrenal glands]]&lt;br /&gt;
rect 201 450 255 491 [[Liver]]&lt;br /&gt;
rect 257 453 324 491 [[Spleen]]&lt;br /&gt;
rect 144 494 239 522 [[Biliary tract]]&lt;br /&gt;
rect 237 491 322 522 [[Pancreas]]&lt;br /&gt;
rect 147 530 201 574 [[Kidney]]&lt;br /&gt;
rect 208 520 247 581 [[Aorta]]&lt;br /&gt;
rect 208 581 278 633 [[Vertebral column]]&lt;br /&gt;
rect 206 520 322 666 [[Stomach and intestines]]&lt;br /&gt;
rect 123 641 178 684 [[Pelvic bones]]&lt;br /&gt;
rect 144 522 208 612 [[Urinary system]]&lt;br /&gt;
rect 193 610 257 692 [[Urinary system]]&lt;br /&gt;
rect 111 692 172 751 [[Hip joint]]&lt;br /&gt;
rect 193 733 247 777 [[Female reproductive system]]&lt;br /&gt;
rect 252 731 304 777 [[Male reproductive system]]&lt;br /&gt;
rect 185 666 316 782 [[Reproductive system]]&lt;br /&gt;
rect 75 756 134 841 [[X-ray of the hip]]&lt;br /&gt;
rect 72 641 178 846 [[Hip]]&lt;br /&gt;
rect 123 427 332 790 [[Abdomen and pelvis]]&lt;br /&gt;
rect 72 846 232 1011 [[Thigh]]&lt;br /&gt;
rect 214 1016 270 1104 [[X-ray of the knee]]&lt;br /&gt;
rect 105 1014 278 1147 [[Knee]]&lt;br /&gt;
rect 103 1147 278 1397 [[Lower leg]]&lt;br /&gt;
rect 216 1399 270 1471 [[X-ray of the ankle]]&lt;br /&gt;
rect 105 1394 278 1474 [[Ankle]]&lt;br /&gt;
rect 193 1479 275 1533 [[X-ray of the foot]]&lt;br /&gt;
rect 105 1474 280 1538 [[Foot]]&lt;br /&gt;
rect 10 1024 82 1124 [[Vascular]]&lt;br /&gt;
rect 13 1132 82 1245 [[Musculoskeletal]]&lt;br /&gt;
rect 10 1371 90 1482 [[Contrast medium reaction]]&lt;br /&gt;
rect 3 1266 98 1487 [[Contrast media]]&lt;br /&gt;
desc bottom-left&lt;br /&gt;
&amp;lt;/imagemap&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-right&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;border:1px solid #cedff2; padding:0; background:#f5faff; vertical-align:top;&amp;quot;|&lt;br /&gt;
&amp;lt;!--        EMERGENCIES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Emergencies&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
*[[Trauma]]&lt;br /&gt;
*[[Stroke]]&lt;br /&gt;
*[[Contrast medium reaction]]&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABOUT        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Radlines:About|About Radlines]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
Radlines is an international, collaborative, non-profit, ad-free and open access encyclopedia in radiology. It is created by doctors, providing quick access to the most relevant information.&lt;br /&gt;
&amp;lt;br&amp;gt;Further information: [[Radlines:About]]&lt;br /&gt;
&amp;lt;div id=&amp;quot;articlecount&amp;quot; style=&amp;quot;font-size:85%;&amp;quot;&amp;gt;[[Special:Statistics|{{NUMBEROFARTICLES}}]] articles.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        CASE OF THE MONTH        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Case of the month&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-otd&amp;quot; style=&amp;quot;padding:0.1em 0.6em 0.5em;&amp;quot;&amp;gt;[[File:Volume rendered CT scan of a pregnancy of 37 weeks of gestational age (thumbnail).gif|left]]&lt;br /&gt;
&amp;lt;br clear=&amp;quot;all&amp;quot;&amp;gt;Volume rendering of a [[CT scan]] of a pregnancy.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABDOMEN AND PELVIS        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Abdomen and pelvis]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
*Modalities: [[CT of the abdomen and pelvis|CT]], [[MRI of the abdomen and pelvis|MRI]], [[Ultrasonography of the abdomen and pelvis|US]], [[X-ray of the abdomen and pelvis|XR]]&lt;br /&gt;
*Systems: [[Digestive system|Digestive]], [[Urinary system|Urinary]] ([[CT of the urinary system|CT]], [[Ultrasonography of the urinary system|US]]), [[Reproductive system|Reproductive]] ([[Male reproductive system|Male]], [[Female reproductive system|Female]])&lt;br /&gt;
*Organs/Regions&lt;br /&gt;
** [[Aorta]]: [[Aortic dissection]]&lt;br /&gt;
** [[Adrenal glands]]:&lt;br /&gt;
** [[Liver]] ([[CT of the liver|CT]], [[MRI of the liver|MRI]], [[Ultrasonography of the liver|US]]): [[Cirrhosis]], [[Steatosis]], [[Liver tumor|Tumor]]&lt;br /&gt;
** [[Gallbladder]], [[Biliary tract]]:&lt;br /&gt;
** [[Kidney]]: [[Hydronephrosis]], [[Kidney stone disease|Stone]], [[Nephrostomy]]&lt;br /&gt;
** [[Ovary]]:&lt;br /&gt;
** [[Pancreas]]: [[Pancreatitis]]&lt;br /&gt;
** [[Prostate]] ([[MRI of the prostate|MRI]], [[Ultrasonography of the prostate|US]])&lt;br /&gt;
** [[Scrotum]] ([[Scrotal ultrasonography|US]])&lt;br /&gt;
** [[Spleen]] ([[Ultrasonography of the spleen|US]])&lt;br /&gt;
** [[Stomach and intestines]]: [[MRI of perianal fistula|Perianal fistula]], [[MRI of rectal cancer|Rectal cancer]]&lt;br /&gt;
** [[Uterus]]: [[Adenomyosis]], [[Endometriosis]], [[Endometrial carcinoma]], [[Leiomyoma]]&lt;br /&gt;
&lt;br /&gt;
&amp;lt;!-- {{Abdomen and pelvis locations}} --&amp;gt;&lt;br /&gt;
&amp;lt;!--        LOCATION UNSPECIFIC DISEASES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Location-unspecific diseases&amp;lt;/h2&amp;gt;&lt;br /&gt;
*[[Cancer]]&lt;br /&gt;
{{Superficial soft tissue diseases}}&lt;br /&gt;
|}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Nephrostomy&amp;diff=3533</id>
		<title>Nephrostomy</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Nephrostomy&amp;diff=3533"/>
		<updated>2019-07-12T20:22:03Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Created page with &amp;quot;See also: * Nephrostomy removal * Nephrostomy change&amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;See also:&lt;br /&gt;
* [[Nephrostomy removal]]&lt;br /&gt;
* [[Nephrostomy change]]&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=CT_of_abdominal_aortic_aneurysm&amp;diff=3532</id>
		<title>CT of abdominal aortic aneurysm</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=CT_of_abdominal_aortic_aneurysm&amp;diff=3532"/>
		<updated>2019-07-12T20:11:27Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Created page with &amp;quot;Because it is a widely available, rapid imaging method, computed tomography (CT) angiography is the exam of choice in such cases.  == Findings == Early identification of imagi...&amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;Because it is a widely available, rapid imaging method, computed tomography (CT) angiography is the exam of choice in such cases.&lt;br /&gt;
&lt;br /&gt;
== Findings ==&lt;br /&gt;
Early identification of imaging findings indicating the rupture or imminent risk of rupture of an AAA can change the prognosis and ensure more appropriate treatment.&lt;br /&gt;
&lt;br /&gt;
'''Rupture'''&lt;br /&gt;
* Retroperitoneal hematoma (most common): translates to a loss of aneurysmal wall integrity and appears on CT as a periaortic focus of soft-tissue density. The hematoma can extend into the pararenal and perirenal spaces, as well as to the psoas muscle and into the intraperitoneal space. In contrast-enhanced images, active extravasation of the contrast agent can be seen.&lt;br /&gt;
&lt;br /&gt;
* [[Draped aorta sign]]: in cases of a ruptured aneurysm contained, neighboring structures such as the vertebral bodies or adjacent retroperitoneal tissues buffer the hemorrhage and the patient may remain hemodynamically stable(1). A CT scan of a contained rupture can show the draped aorta sign, in which neither the posterior wall of the aorta nor the periaortic fat plane is distinguishable.&lt;br /&gt;
&lt;br /&gt;
'''Imminent rupture'''&lt;br /&gt;
* The maximum diameter and growth rate of an aneurysm are the most common predictors of its rupture, underscoring the importance of serial imaging in the follow-up of patients with an AAA. In most cases of typical fusiform aneurysms, a surgical approach is indicated if the aneurysm diameter is &amp;gt; 5.4 cm or the aneurysm grows by more than 5 mm over a six-month period.&lt;br /&gt;
&lt;br /&gt;
* [[Hyperattenuating crescent sign]]: corresponds to a hyperattenuating peripheral area within the wall of the aorta or within a mural thrombus, indicating infiltration of blood from the lumen of the aneurysm into those structures, with consequent weakening of the wall of the aneurysm. The hyperattenuating crescent sign is best visualized on unenhanced CT scans and is characterized by attenuation greater than that of intraluminal blood.&lt;br /&gt;
&lt;br /&gt;
* Focal discontinuity of parietal circumferential calcification: can indicate that an aneurysm is unstable. That is especially relevant when the discontinuity is new or there are new outpouchings(1,5).&lt;br /&gt;
&lt;br /&gt;
* Penetrating atherosclerotic ulcers: although less common in AAAs than in thoracic aortic aneurysms, they also indicates that an aneurysm is unstable. The expansion of such ulcers increases the risk of outpouching and rupture.&lt;br /&gt;
&lt;br /&gt;
== Communication ==&lt;br /&gt;
&lt;br /&gt;
Abdominal aortic aneurysm rupture is a medical emergency associated with extremely high mortality and therefore requiring immediate surgical treatment.  Referring doctor should be contacted.&lt;br /&gt;
&lt;br /&gt;
== References==&lt;br /&gt;
CORREA, Ingrid Braga et al. Abdominal aortic aneurysms that have ruptured or are at imminent risk of rupture. Radiol Bras [online]. 2019, vol.52, n.3 [cited  2019-07-12], pp.182-186. Available from: &amp;lt;http://www.scielo.br/scielo.php?script=sci_arttext&amp;amp;pid=S0100-39842019000300182&amp;amp;lng=en&amp;amp;nrm=iso&amp;gt;.  Epub June 13, 2019. ISSN 0100-3984.  http://dx.doi.org/10.1590/0100-3984.2017.0096.&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=CT_of_abdominal_aneurysm&amp;diff=3531</id>
		<title>CT of abdominal aneurysm</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=CT_of_abdominal_aneurysm&amp;diff=3531"/>
		<updated>2019-07-12T19:56:24Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Abdominal aortic aneurysm */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
==Choice of modality==&lt;br /&gt;
'''[[Ultrasonography of abdominal aneurysm]]''' is generally the first choice, but abdominal aneurysms are often seen incidentally in [[abdominal CT]]s.&lt;br /&gt;
&lt;br /&gt;
==Abdominal aortic aneurysm==&lt;br /&gt;
{{Diameters of abdominal aorta}}&lt;br /&gt;
&lt;br /&gt;
*See [[CT of abdominal aortic aneurysm]]&lt;br /&gt;
&lt;br /&gt;
Abdominal aortic aneurysms are commonly divided according to their size and symptomatology. An aneurysm is usually defined as an outer aortic diameter over 3&amp;amp;nbsp;cm (normal diameter of the aorta is around 2&amp;amp;nbsp;cm),&amp;lt;ref name=ACC2005&amp;gt;{{cite journal |vauthors=Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B | title = ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease)—summary of recommendations | journal = J Vasc Interv Radiol | volume = 17 | issue = 9 | pages = 1383–97; quiz 1398 | date = September 2006 | pmid = 16990459 | doi = 10.1097/01.RVI.0000240426.53079.46 }}&amp;lt;/ref&amp;gt; or more than 50% of normal diameter.&amp;lt;ref name=&amp;quot;SolomonKent2014&amp;quot;&amp;gt;{{cite journal|last1=Solomon|first1=Caren G.|last2=Kent|first2=K. Craig|title=Abdominal Aortic Aneurysms|journal=New England Journal of Medicine|volume=371|issue=22|year=2014|pages=2101–2108|issn=0028-4793|doi=10.1056/NEJMcp1401430|pmid=25427112}}&amp;lt;/ref&amp;gt; The suprarenal aorta normally measures about 0.5 cm larger than the infrarenal aorta.&amp;lt;ref&amp;gt;{{cite web|url=https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-abdominal-aortic-aneurysm|title=Clinical features and diagnosis of abdominal aortic aneurysm|author=Jeffrey Jim, Robert W Thompson|website=[[UpToDate]]|date=2018-03-05|deadurl=no|archiveurl=https://web.archive.org/web/20180330212246/https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-abdominal-aortic-aneurysm|archivedate=2018-03-30|df=}}&amp;lt;/ref&amp;gt;&lt;br /&gt;
&lt;br /&gt;
==Common iliac artery aneurysm==&lt;br /&gt;
{{Diameters of common iliac artery}}&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Main&amp;diff=3530</id>
		<title>Main</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Main&amp;diff=3530"/>
		<updated>2019-07-12T19:49:22Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&amp;lt;!--        BANNER ACROSS TOP OF PAGE         --&amp;gt;__NOTOC__&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-topbanner&amp;quot; style=&amp;quot;clear:both; position:relative; box-sizing:border-box; width:100%; margin:1.2em 0 6px; min-width:20em; border:1px solid #ddd; background-color:#f9f9f9; color:#000;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;!--        &amp;quot;WELCOME TO RADLINES&amp;quot;        --&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;margin:0.4em; text-align:center;&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;div style=&amp;quot;font-size:162%; padding:.1em;&amp;quot;&amp;gt;Welcome to [[Radlines:About|Radlines]], open access guidelines for radiologists.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
{| role=&amp;quot;presentation&amp;quot; id=&amp;quot;mp-upper&amp;quot; style=&amp;quot;width: 100%; margin-top:4px; border-spacing: 0px;&amp;quot;&lt;br /&gt;
&amp;lt;!--        MENU IMAGE        --&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-left&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;width:339px; border:1px solid #cef2e0; padding:0; background:#f5fffa; vertical-align:top; color:#000;&amp;quot; |&lt;br /&gt;
&amp;lt;imagemap&amp;gt;&lt;br /&gt;
File:Anatomy_image_for_main_menu.png|&lt;br /&gt;
rect 0 23 82 126 [[Projectional radiography]]&lt;br /&gt;
rect 87 23 136 126 [[CT]]&lt;br /&gt;
rect 0 129 80 198 [[Ultrasonography]]&lt;br /&gt;
rect 85 126 141 198 [[MRI]]&lt;br /&gt;
rect 0 198 90 260 [[Fluoroscopy]]&lt;br /&gt;
rect 175 51 219 121 [[CT of the head]]&lt;br /&gt;
rect 234 54 278 121 [[MRI of the head]]&lt;br /&gt;
rect 149 8 329 159 [[Head]]&lt;br /&gt;
rect 170 180 232 221 [[CT of the neck]]&lt;br /&gt;
rect 237 180 311 221 [[X-ray of the cervical spine]]&lt;br /&gt;
rect 162 224 265 270 [[Thyroid]]&lt;br /&gt;
rect 147 162 332 273 [[Neck]]&lt;br /&gt;
rect 28 296 82 365 [[X-ray of the shoulder]]&lt;br /&gt;
rect 28 270 131 370 [[Shoulder]]&lt;br /&gt;
rect 21 373 126 489 [[Upper arm]]&lt;br /&gt;
rect 21 515 72 574 [[X-ray of the elbow]]&lt;br /&gt;
rect 18 491 123 579 [[Elbow]]&lt;br /&gt;
rect 3 579 111 635 [[Forearm]]&lt;br /&gt;
rect 5 659 59 725 [[X-ray of the wrist]]&lt;br /&gt;
rect 3 635 69 733 [[Wrist]]&lt;br /&gt;
rect 10 759 59 823 [[X-ray of the hand]]&lt;br /&gt;
rect 3 736 67 875 [[Hand]]&lt;br /&gt;
rect 139 293 196 365 [[X-ray of the thorax]]&lt;br /&gt;
rect 206 293 257 363 [[CT of the thorax]]&lt;br /&gt;
rect 136 373 203 424 [[Breast]]&lt;br /&gt;
rect 211 394 275 419 [[Heart]]&lt;br /&gt;
rect 206 368 306 422 [[Vascular]]&lt;br /&gt;
rect 131 270 329 427 [[Thorax]]&lt;br /&gt;
rect 141 453 203 491 [[Adrenal glands]]&lt;br /&gt;
rect 201 450 255 491 [[Liver]]&lt;br /&gt;
rect 257 453 324 491 [[Spleen]]&lt;br /&gt;
rect 144 494 239 522 [[Biliary tract]]&lt;br /&gt;
rect 237 491 322 522 [[Pancreas]]&lt;br /&gt;
rect 147 530 201 574 [[Kidney]]&lt;br /&gt;
rect 208 520 247 581 [[Aorta]]&lt;br /&gt;
rect 208 581 278 633 [[Vertebral column]]&lt;br /&gt;
rect 206 520 322 666 [[Stomach and intestines]]&lt;br /&gt;
rect 123 641 178 684 [[Pelvic bones]]&lt;br /&gt;
rect 144 522 208 612 [[Urinary system]]&lt;br /&gt;
rect 193 610 257 692 [[Urinary system]]&lt;br /&gt;
rect 111 692 172 751 [[Hip joint]]&lt;br /&gt;
rect 193 733 247 777 [[Female reproductive system]]&lt;br /&gt;
rect 252 731 304 777 [[Male reproductive system]]&lt;br /&gt;
rect 185 666 316 782 [[Reproductive system]]&lt;br /&gt;
rect 75 756 134 841 [[X-ray of the hip]]&lt;br /&gt;
rect 72 641 178 846 [[Hip]]&lt;br /&gt;
rect 123 427 332 790 [[Abdomen and pelvis]]&lt;br /&gt;
rect 72 846 232 1011 [[Thigh]]&lt;br /&gt;
rect 214 1016 270 1104 [[X-ray of the knee]]&lt;br /&gt;
rect 105 1014 278 1147 [[Knee]]&lt;br /&gt;
rect 103 1147 278 1397 [[Lower leg]]&lt;br /&gt;
rect 216 1399 270 1471 [[X-ray of the ankle]]&lt;br /&gt;
rect 105 1394 278 1474 [[Ankle]]&lt;br /&gt;
rect 193 1479 275 1533 [[X-ray of the foot]]&lt;br /&gt;
rect 105 1474 280 1538 [[Foot]]&lt;br /&gt;
rect 10 1024 82 1124 [[Vascular]]&lt;br /&gt;
rect 13 1132 82 1245 [[Musculoskeletal]]&lt;br /&gt;
rect 10 1371 90 1482 [[Contrast medium reaction]]&lt;br /&gt;
rect 3 1266 98 1487 [[Contrast media]]&lt;br /&gt;
desc bottom-left&lt;br /&gt;
&amp;lt;/imagemap&amp;gt;&lt;br /&gt;
| id=&amp;quot;mp-right&amp;quot; class=&amp;quot;MainPageBG&amp;quot; style=&amp;quot;border:1px solid #cedff2; padding:0; background:#f5faff; vertical-align:top;&amp;quot;|&lt;br /&gt;
&amp;lt;!--        EMERGENCIES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Emergencies&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
*[[Trauma]]&lt;br /&gt;
*[[Stroke]]&lt;br /&gt;
*[[Contrast medium reaction]]&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABOUT        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-itn-h2&amp;quot; style=&amp;quot;margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Radlines:About|About Radlines]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-itn&amp;quot; style=&amp;quot;padding:0.1em 0.6em;&amp;quot;&amp;gt;&lt;br /&gt;
Radlines is an international, collaborative, non-profit, ad-free and open access encyclopedia in radiology. It is created by doctors, providing quick access to the most relevant information.&lt;br /&gt;
&amp;lt;br&amp;gt;Further information: [[Radlines:About]]&lt;br /&gt;
&amp;lt;div id=&amp;quot;articlecount&amp;quot; style=&amp;quot;font-size:85%;&amp;quot;&amp;gt;[[Special:Statistics|{{NUMBEROFARTICLES}}]] articles.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        CASE OF THE MONTH        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Case of the month&amp;lt;/h2&amp;gt;&lt;br /&gt;
&amp;lt;div id=&amp;quot;mp-otd&amp;quot; style=&amp;quot;padding:0.1em 0.6em 0.5em;&amp;quot;&amp;gt;[[File:Volume rendered CT scan of a pregnancy of 37 weeks of gestational age (thumbnail).gif|left]]&lt;br /&gt;
&amp;lt;br clear=&amp;quot;all&amp;quot;&amp;gt;Volume rendering of a [[CT scan]] of a pregnancy.&amp;lt;/div&amp;gt;&lt;br /&gt;
&amp;lt;!--        ABDOMEN AND PELVIS        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;[[Abdomen and pelvis]]&amp;lt;/h2&amp;gt;&lt;br /&gt;
*Modalities: [[CT of the abdomen and pelvis|CT]], [[MRI of the abdomen and pelvis|MRI]], [[Ultrasonography of the abdomen and pelvis|US]], [[X-ray of the abdomen and pelvis|XR]]&lt;br /&gt;
*Systems: [[Digestive system|Digestive]], [[Urinary system|Urinary]] ([[CT of the urinary system|CT]], [[Ultrasonography of the urinary system|US]]), [[Reproductive system|Reproductive]] ([[Male reproductive system|Male]], [[Female reproductive system|Female]])&lt;br /&gt;
*Organs/Regions&lt;br /&gt;
** [[Aorta]]: [[Aortic dissection]]&lt;br /&gt;
** [[Adrenal glands]]:&lt;br /&gt;
** [[Liver]] ([[CT of the liver|CT]], [[MRI of the liver|MRI]], [[Ultrasonography of the liver|US]]): [[Cirrhosis]], [[Steatosis]], [[Liver tumor|Tumor]]&lt;br /&gt;
** [[Gallbladder]], [[Biliary tract]]:&lt;br /&gt;
** [[Kidney]]&lt;br /&gt;
** [[Pancreas]]: [[Pancreatitis]]&lt;br /&gt;
** [[Prostate]] ([[MRI of the prostate|MRI]], [[Ultrasonography of the prostate|US]])&lt;br /&gt;
** [[Scrotum]] ([[Scrotal ultrasonography|US]])&lt;br /&gt;
** [[Spleen]] ([[Ultrasonography of the spleen|US]])&lt;br /&gt;
** [[Stomach and intestines]]: [[MRI of perianal fistula|Perianal fistula]]&lt;br /&gt;
&lt;br /&gt;
&amp;lt;!-- {{Abdomen and pelvis locations}} --&amp;gt;&lt;br /&gt;
&amp;lt;!--        LOCATION UNSPECIFIC DISEASES        --&amp;gt;&lt;br /&gt;
&amp;lt;h2 id=&amp;quot;mp-otd-h2&amp;quot; style=&amp;quot;clear:both; margin:0.5em; background:#cedff2; font-family:inherit; font-size:120%; font-weight:bold; border:1px solid #a3b0bf; color:#000; padding:0.2em 0.4em;&amp;quot;&amp;gt;Location-unspecific diseases&amp;lt;/h2&amp;gt;&lt;br /&gt;
*[[Cancer]]&lt;br /&gt;
{{Superficial soft tissue diseases}}&lt;br /&gt;
|}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Steatosis&amp;diff=3529</id>
		<title>Steatosis</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Steatosis&amp;diff=3529"/>
		<updated>2019-07-12T18:41:33Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Planning */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
==Planning==&lt;br /&gt;
&lt;br /&gt;
===Ultrasound===&lt;br /&gt;
*Main article: '''[[Ultrasonography of steatosis]]'''&lt;br /&gt;
&lt;br /&gt;
Ultrasound is a good method for screening. &lt;br /&gt;
&lt;br /&gt;
Steatosis is displayed as a liver with an ecogenicity higher than usual.&lt;br /&gt;
&lt;br /&gt;
Quantification can be done, but it is not as accurate as MRI.&lt;br /&gt;
&lt;br /&gt;
=== MRI===&lt;br /&gt;
*Main article: '''[[MRI of liver steatosis]].&lt;br /&gt;
&lt;br /&gt;
MRI is the most accurate method to quantify liver steatosis. &lt;br /&gt;
&lt;br /&gt;
=== Computed tomography ===&lt;br /&gt;
CT should not be used to detect or stage liver steatosis.&lt;br /&gt;
&lt;br /&gt;
Steatosis on [[CT]] is displayed as a liver with attenuation lower than usual. &lt;br /&gt;
&lt;br /&gt;
CT has high sensitivity for moderate and severe steatosis, but lower for mild steatosis.&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
{{Steatosis - how soon}}&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Steatosis&amp;diff=3528</id>
		<title>Steatosis</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Steatosis&amp;diff=3528"/>
		<updated>2019-07-12T18:29:34Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Choice of modality */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
==Planning==&lt;br /&gt;
===Choice of modality===&lt;br /&gt;
*'''[[Ultrasonography of steatosis]]'''&lt;br /&gt;
*'''[[MRI of liver steatosis]]&lt;br /&gt;
&lt;br /&gt;
{{Steatosis - how soon}}&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Steatosis&amp;diff=3527</id>
		<title>Steatosis</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Steatosis&amp;diff=3527"/>
		<updated>2019-07-12T18:29:04Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: /* Choice of modality */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Mikael Häggström|Mikael Häggström]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
==Planning==&lt;br /&gt;
===Choice of modality===&lt;br /&gt;
'''[[Ultrasonography of steatosis]]'''&lt;br /&gt;
'''[[MRI of liver steatosis]]&lt;br /&gt;
&lt;br /&gt;
{{Steatosis - how soon}}&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3526</id>
		<title>MRI of the liver</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3526"/>
		<updated>2019-07-12T18:20:22Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
[[File:MRI of Caroli disease (d).jpg|right]]&lt;br /&gt;
&lt;br /&gt;
==Technique==&lt;br /&gt;
Requires a phased array torso [[coil]].&lt;br /&gt;
&lt;br /&gt;
==Basic screening==&lt;br /&gt;
*'''Morphology''': verify size, borders and contours.&lt;br /&gt;
*'''Liver parenchyma''': Scan for steatosis, iron deposition&lt;br /&gt;
*'''Focal lesions''': Scan for nodules&lt;br /&gt;
*'''Biliary ducts''':&lt;br /&gt;
*'''Hepatic veins'''&lt;br /&gt;
*'''Portal vein'''&lt;br /&gt;
&lt;br /&gt;
'''Search for extrahepatic findings'''&lt;br /&gt;
*'''Lymph''' nodes in hepatic hilum.&lt;br /&gt;
*Signs of portal hypertension: [[ascites]], [[splenomegaly]]; portosystemic collateral vessels&lt;br /&gt;
&lt;br /&gt;
==Report==&lt;br /&gt;
&lt;br /&gt;
[[LI-RADS]] (Liver Imaging and Reporting Data System) system should be used only if patient has a high risk for hepatocellular carcinoma (cirrhosis, chronic hepatitis B or current/prior HCC).&lt;br /&gt;
&lt;br /&gt;
==Lesions and diseases==&lt;br /&gt;
*[[Fatty liver disease]]: [[Steatosis|Liver steatosis]], [[Nonalcoholic steatohepatitis|NASH]];&lt;br /&gt;
*[[Liver iron deposition]]&lt;br /&gt;
*[[Cirrhosis]]&lt;br /&gt;
*[[Autoimmune hepatitis]]&lt;br /&gt;
*[[Primary biliary cirrhosis]]&lt;br /&gt;
*[[Primary sclerosing cholangitis]]&lt;br /&gt;
*[[Hepatic hemangioma]]&lt;br /&gt;
*[[Hepatic adenoma]]&lt;br /&gt;
*[[Focal nodular hyperplasia]]&lt;br /&gt;
*[[Hepatocellular carcinoma]]&lt;br /&gt;
*[[Cholangiocarcinoma]]&lt;br /&gt;
*[[Liver metastases]]&lt;br /&gt;
*[[Budd-Chiari syndrome]]&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3525</id>
		<title>MRI of the liver</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3525"/>
		<updated>2019-07-12T18:19:07Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
&lt;br /&gt;
[[File:MRI of Caroli disease (d).jpg|right]]&lt;br /&gt;
&lt;br /&gt;
==Technique==&lt;br /&gt;
Requires a phased array torso [[coil]].&lt;br /&gt;
&lt;br /&gt;
==Basic screening==&lt;br /&gt;
*'''Morphology''': verify size, borders and contours.&lt;br /&gt;
*'''Liver parenchyma''': Scan for steatosis, iron deposition&lt;br /&gt;
*'''Focal lesions''': Scan for nodules&lt;br /&gt;
*'''Biliary ducts''':&lt;br /&gt;
*'''Hepatic veins'''&lt;br /&gt;
*'''Portal vein'''&lt;br /&gt;
&lt;br /&gt;
Search for extrahepatic findings&lt;br /&gt;
*'''Lymph''' nodes in hepatic hilum.&lt;br /&gt;
*Signs of portal hypertension: [[ascites]], [[splenomegaly]]; portosystemic collateral vessels&lt;br /&gt;
&lt;br /&gt;
===Report===&lt;br /&gt;
&lt;br /&gt;
[[LI-RADS]] (Liver Imaging and Reporting Data System) system should be used only if patient has a high risk for hepatocellular carcinoma (cirrhosis, chronic hepatitis B or current/prior HCC).&lt;br /&gt;
&lt;br /&gt;
==Lesions and diseases==&lt;br /&gt;
*[[Fatty liver disease]]: [[Steatosis|Liver steatosis]], [[Nonalcoholic steatohepatitis|NASH]];&lt;br /&gt;
*[[Liver iron deposition]]&lt;br /&gt;
*[[Cirrhosis]]&lt;br /&gt;
*[[Autoimmune hepatitis]]&lt;br /&gt;
*[[Primary biliary cirrhosis]]&lt;br /&gt;
*[[Primary sclerosing cholangitis]]&lt;br /&gt;
*[[Hepatic hemangioma]]&lt;br /&gt;
*[[Hepatic adenoma]]&lt;br /&gt;
*[[Focal nodular hyperplasia]]&lt;br /&gt;
*[[Hepatocellular carcinoma]]&lt;br /&gt;
*[[Cholangiocarcinoma]]&lt;br /&gt;
*[[Liver metastases]]&lt;br /&gt;
*[[Budd-Chiari syndrome]]&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3524</id>
		<title>MRI of the liver</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=MRI_of_the_liver&amp;diff=3524"/>
		<updated>2019-07-12T18:15:24Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: Created page with &amp;quot;{{Top |author1=Rodrigo Horstmann Castilhos |author2= }} ==Technique== Requires a phased array torso coil.  ==Basic screening== *'''Morphology''': veri...&amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Top&lt;br /&gt;
|author1=[[User:Rhcastilhos|Rodrigo Horstmann Castilhos]]&lt;br /&gt;
|author2=&lt;br /&gt;
}}&lt;br /&gt;
==Technique==&lt;br /&gt;
Requires a phased array torso [[coil]].&lt;br /&gt;
&lt;br /&gt;
==Basic screening==&lt;br /&gt;
*'''Morphology''': verify size, borders and contours.&lt;br /&gt;
*'''Liver parenchyma''': Scan for steatosis, iron deposition&lt;br /&gt;
*'''Focal lesions''': Scan for nodules&lt;br /&gt;
*'''Biliary ducts''':&lt;br /&gt;
*'''Hepatic veins'''&lt;br /&gt;
*'''Portal vein'''&lt;br /&gt;
&lt;br /&gt;
Search for extrahepatic findings&lt;br /&gt;
*'''Lymph''' nodes in hepatic hilum.&lt;br /&gt;
*Signs of portal hypertension: [[ascites]], [[splenomegaly]]; portosystemic collateral vessels&lt;br /&gt;
&lt;br /&gt;
===Report===&lt;br /&gt;
&lt;br /&gt;
[[LI-RADS]] (Liver Imaging and Reporting Data System) system should be used only if patient has a high risk for hepatocellular carcinoma (cirrhosis, chronic hepatitis B or current/prior HCC).&lt;br /&gt;
&lt;br /&gt;
==Lesions and diseases==&lt;br /&gt;
*[[Fatty liver disease]]: [[Steatosis|Liver steatosis]], [[Nonalcoholic steatohepatitis|NASH]];&lt;br /&gt;
*[[Liver iron deposition]]&lt;br /&gt;
*[[Cirrhosis]]&lt;br /&gt;
*[[Autoimmune hepatitis]]&lt;br /&gt;
*[[Primary biliary cirrhosis]]&lt;br /&gt;
*[[Primary sclerosing cholangitis]]&lt;br /&gt;
*[[Hepatic hemangioma]]&lt;br /&gt;
*[[Hepatic adenoma]]&lt;br /&gt;
*[[Focal nodular hyperplasia]]&lt;br /&gt;
*[[Hepatocellular carcinoma]]&lt;br /&gt;
*[[Cholangiocarcinoma]]&lt;br /&gt;
*[[Liver metastases]]&lt;br /&gt;
*[[Budd-Chiari syndrome]]&lt;br /&gt;
&lt;br /&gt;
{{Bottom}}&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
	<entry>
		<id>https://radlines.org/index.php?title=Liver&amp;diff=3523</id>
		<title>Liver</title>
		<link rel="alternate" type="text/html" href="https://radlines.org/index.php?title=Liver&amp;diff=3523"/>
		<updated>2019-07-12T17:42:59Z</updated>

		<summary type="html">&lt;p&gt;Rhcastilhos: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;==Modalities==&lt;br /&gt;
&amp;lt;gallery&amp;gt;&lt;br /&gt;
File:Liver measurements on ultrasonography.jpg|link=Ultrasonography of the liver|[[Ultrasonography of the liver|'''Ultrasonography''' of the liver]]&lt;br /&gt;
File:CT of the liver.jpg|link=CT of the liver|[[CT of the liver|'''CT''' of the liver]]&lt;br /&gt;
File:MRI of Caroli disease (d).jpg|link=MRI of the liver|[[MRI of the liver|'''MRI''' of the liver]]&lt;br /&gt;
&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;/div&gt;</summary>
		<author><name>Rhcastilhos</name></author>
		
	</entry>
</feed>