Solitary rectal ulcer syndrome: MRI findings and differentiation from rectal cancer.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-06-16 DOI:10.1186/s13244-025-01979-7

Peiyi Xie, Xiaoying Lou, Shuai Fu, Xiaohui Di, Qitong Huang, Zhiming Zeng, Kexin Niu, Junying Zhu, Meiyu Hu, Xiaochun Meng

{"title":"Solitary rectal ulcer syndrome: MRI findings and differentiation from rectal cancer.","authors":"Peiyi Xie, Xiaoying Lou, Shuai Fu, Xiaohui Di, Qitong Huang, Zhiming Zeng, Kexin Niu, Junying Zhu, Meiyu Hu, Xiaochun Meng","doi":"10.1186/s13244-025-01979-7","DOIUrl":null,"url":null,"abstract":"Background: Systematic MRI findings of solitary rectal ulcer syndrome (SRUS) are lacking. We aimed to evaluate the MRI findings of SRUS and to identify the MRI features that differentiate SRUS from rectal cancer.Methods: This retrospective study consecutively included 30 patients diagnosed with SRUS from January 2015 to December 2021. The clinical and MRI findings of SRUS patients were summarized. We randomly selected 120 rectal cancer patients with ≤ T2N0 pathological staging in a 1:4 ratio of SRUS to rectal cancer cases to perform differential diagnosis analysis.Results: SRUS patients were significantly younger (mean age ± standard deviation [SD], 37 years ± 17; 22 men) than rectal cancer patients (mean age ± SD, 62 years ± 12; 67 men; p < 0.001). Compared to rectal cancer patients, SRUS patients had a significantly higher incidence of ulceration (63.33%), submucosal edema (36.67%), unrestricted diffusion (76.67%), hypo- or high-low mixed intensity on T2-weighted imaging (T2WI, 76.67%), and layer enhancement (40%) (all p < 0.001). Interestingly, in the combinations of MRI features including unrestricted diffusion, hypo- or high-low mixed intensity on T2WI, and layer enhancement or submucosal edema showed an excellent diagnostic performance with area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 0.97 (95% CI: 0.92, 1.00), 93%, 100%, 100%, 98%, and 99%, respectively, in differentiating SRUS from rectal cancer.Conclusion: The combinations of three MRI features are simple and show excellent diagnostic performance. These may be useful tools for differentiating SRUS from rectal cancer.Critical relevance statement: The combinations of three MRI features including unrestricted diffusion, hypo- or high-low mixed intensity on T2WI, and layer enhancement or submucosal edema show excellent diagnostic performance, which have potential to serve as useful tools for differentiating SRUS from rectal cancer.Key points: MRI could differentiate solitary rectal ulcer syndrome (SRUS) from rectal cancer. SRUS patients had a significantly higher incidence of several MRI features. The combinations have potential for differentiating SRUS from rectal cancer.","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"126"},"PeriodicalIF":4.1000,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170985/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Insights into Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13244-025-01979-7","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Systematic MRI findings of solitary rectal ulcer syndrome (SRUS) are lacking. We aimed to evaluate the MRI findings of SRUS and to identify the MRI features that differentiate SRUS from rectal cancer.

Methods: This retrospective study consecutively included 30 patients diagnosed with SRUS from January 2015 to December 2021. The clinical and MRI findings of SRUS patients were summarized. We randomly selected 120 rectal cancer patients with ≤ T2N0 pathological staging in a 1:4 ratio of SRUS to rectal cancer cases to perform differential diagnosis analysis.

Results: SRUS patients were significantly younger (mean age ± standard deviation [SD], 37 years ± 17; 22 men) than rectal cancer patients (mean age ± SD, 62 years ± 12; 67 men; p < 0.001). Compared to rectal cancer patients, SRUS patients had a significantly higher incidence of ulceration (63.33%), submucosal edema (36.67%), unrestricted diffusion (76.67%), hypo- or high-low mixed intensity on T2-weighted imaging (T2WI, 76.67%), and layer enhancement (40%) (all p < 0.001). Interestingly, in the combinations of MRI features including unrestricted diffusion, hypo- or high-low mixed intensity on T2WI, and layer enhancement or submucosal edema showed an excellent diagnostic performance with area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 0.97 (95% CI: 0.92, 1.00), 93%, 100%, 100%, 98%, and 99%, respectively, in differentiating SRUS from rectal cancer.

Conclusion: The combinations of three MRI features are simple and show excellent diagnostic performance. These may be useful tools for differentiating SRUS from rectal cancer.

Critical relevance statement: The combinations of three MRI features including unrestricted diffusion, hypo- or high-low mixed intensity on T2WI, and layer enhancement or submucosal edema show excellent diagnostic performance, which have potential to serve as useful tools for differentiating SRUS from rectal cancer.

Key points: MRI could differentiate solitary rectal ulcer syndrome (SRUS) from rectal cancer. SRUS patients had a significantly higher incidence of several MRI features. The combinations have potential for differentiating SRUS from rectal cancer.

查看原文本刊更多论文

孤立性直肠溃疡综合征：MRI表现及与直肠癌的鉴别。

背景：缺乏孤立性直肠溃疡综合征（SRUS）的系统MRI表现。我们的目的是评估SRUS的MRI表现，并确定区分SRUS与直肠癌的MRI特征。方法：本回顾性研究连续纳入2015年1月至2021年12月诊断为SRUS的30例患者。总结SRUS患者的临床及MRI表现。我们随机选取120例病理分期≤T2N0的直肠癌患者，按SRUS与直肠癌病例1:4的比例进行鉴别诊断分析。结果：SRUS患者明显年轻化(平均年龄±标准差[SD]， 37岁±17岁；22名男性)大于直肠癌患者(平均年龄±SD， 62岁±12岁；67人;结论：三种MRI征象的结合简便，具有较好的诊断价值。这些可能是区分SRUS和直肠癌的有用工具。关键相关性声明：无限制扩散、T2WI低或高低混合强度、层强化或粘膜下水肿这三种MRI特征的结合表现出极好的诊断效果，有可能作为区分SRUS与直肠癌的有用工具。重点：MRI可鉴别孤立性直肠溃疡综合征（SRUS）与直肠癌。SRUS患者的一些MRI特征的发生率明显更高。这些组合有可能区分SRUS和直肠癌。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.