| Carcinoma of rectum are at the junction of the sigmoid colon to the dentate line between cancer, digestive system, one of common malignant tumor, its incidence and mortality in Europe and the United States and other Western countries at the Home of the second tumor deaths, colorectal cancer at The incidence of malignant neoplasms and mortality in China accounted for the first four.At present, the worldwide cancer morbidity and mortality continues to increase. Carcinoma of rectum surgery are the main treatment, the early eighties of the last century, Total mesorectal excision (TME) has been proposed and used clinically, the larger the lower the rate of local recurrence of rectal cancer, the use of reasonable methods of imaging examinations preoperative staging of rectal cancer, TME surgery and preoperative evaluation with a view to clinicians select treatment programs provide an important reference information, will seem more important. For preoperative staging of rectal cancer has the main method of imaging: Endoscopicul trasound (EUS), Multi-slice computed tomography(MSCT), MRI and so on. EUS of rectal wall layers show a good structure, be able to more accurately reflect the rectal tumor at the level of infiltration of the intestinal wall, and rectal endosonography with no radiation, low cost, convenient and easy. But when mesocaval narrow to a certain extent can not be entered after the probe, and rectal cancer at pelvic ultrasonography showed poor distant metastasis, tumor lesions smaller high rate of missed diagnosis. In addition the accuracy of ultrasound diagnosis of the experience of the operator must have a dependent. MSCT in preoperative staging of rectal cancer is the imaging method of MS CT has a good density resolution imaging to large-scale thin-layer, scanning speed, check the pain.Multi-slice spiral CT of the relationship between cancer and the performance of the surrounding organs, but the CT because of poor soft tissue resolution, it is rather difficult to distinguish the rectum wall on each floor, with rectal endosonography, MRI compared with low accuracy. MRI high soft tissue resolution and multi-directional imaging feasible, can be more clearly shows the three-tier structure of the rectum and can show good tumor, rectum, and fat around the organs, MRI to determine the extent of violations of the capacity of the intestinal wall and rectal ultrasound near are superior to pelvic CT. It is worth noting that both the rectal endosonography, CT, MRI of rectal cancer are not high accuracy of N staging of regional lymph node metastasis in lymph nodes should determine the size, shape, internal signal or density changes in General judge. Pathological stage after the 2002 UICC (International Union Against Cancer) standard developed in phases. The following criteria: (1) T primary tumor. Tix: unable to assess the primary tumor; T1: primary tumor and submucosal invasion; T2: primary tumor invasion and the inherent muscle; T3: primary cancer penetrating muscular layer to the inherent non-infringement under the serosa surrounding tissue; T4 period : surrounding tissue tumor. (2) N: regional lymph nodes. Nx Regional lymph node status can not be determined; N0: no regional lymph node metastasis; N1 have 1-3 regional lymph node metastasis; N2 have four or more regional lymph node metastasis.MRI and CT can be of mesorectal fascia involvement (that is, TME surgery circumcision edge) to assess, because MRI has better soft tissue resolution, MRI on the extent of mesorectal fascia appear more clear, more precise determination can be mesorectal fascia involvement. Anal margin of rectal cancer with rectal cancer surgery is the distance from anus to consider the issue of one of the key issues, such as through appropriate pre-operative imaging of rectal examination and anal edge of accurate assessment of distance, and then for clinical procedure the choice of reference, a certain degree of clinical significance. Digital rectal examination is commonly used in cancer clinical examination, simple to check the use of colorectal cancer to determine the index finger pulp of the lower edge of the most in the index finger and anal margin at the junction marked, remove the index, the measurement and recording with Gauge measured values. MRI measurement of cancer selected sagittal MRI scan T1 fat-suppressed images, since the lower edge of colorectal cancer, along the curvature of the rectum, the use of MRI measurement curves calculated with the lower edge of tumor distance from the anal margin. As a result of the median, the location of colorectal cancer a higher high, the lower edge of the tumor margin and the distance between anal sphincter-saving surgery is not the key issues to consider. Therefore, this study and tumor distance from anal margin of the study for low rectal cancer.Methods: Select from April 2007 to December 2008 total mesorectal cut line for the treatment of 31 cases of rectal cancer patients, including 15 cases of low rectal cancer. All patients underwent preoperative MRI scan, scan sent to the workstation, in accordance with the depth of tumor infiltration of the intestinal wall, the scope of regional lymph node metastasis, TN to determine tumor staging, to determine whether the mesorectal fascia involvement and to make use of imaging technology curve measured in patients with low rectal tumor distance from the anal margin.Results: SPSS13.0 statistical software to test conformance T staging, staging and mesorectal fascia involvement, in which the overall accuracy of T staging was 74.1%, kappa value was 0.630, N staging accuracy was 67.7%, kappa value of 0.509. Mesorectal fascia MRI to determine the correct rate of involvement 90.3%, kappa value was 0.784. MRI curve will be measured with the lower edge of the tumor from the anal margin and the digital rectal clinic data measured T test, P values greater than 0.05, the two there was no significant difference.Conclusion: :MRI prognosticates the clinical TN staging of rectal carcinoma accurately, which provides inportant clinical informations for preoperative evaluation of total mesorectum excision.
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