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Colorectal carcinomas can broadly be classified as either non-mucinous or mucinous. Usually, mucinous adenocarcinomas present at a more advanced stage, have more aggressive local spread and have an increased incidence of lymph node involvement. Screening Computed Tomography (CT) is widely used for the initial evaluation of these tumours. Study objective was to retrospectively analyse the CT images of rectal carcinomas and suggest parameters to aid differentiation of mucinous and non-mucinous tumours. Materials and methods: The CT images of 25 cases of mucinous and 27 cases of non-mucinous adenocarcinoma were retrospectively studied and evaluated for parameters like morphology, wall thickness, size, pattern and degree of enhancement. Also, evaluated was involvement of adjacent structures, lymph nodes and distant metastases. SPSS Version 22.0 was used for analysis. All the parameters were analysed for significance using the chi-square test. Results: Mucinous adenocarcinomas of the rectum showed a greater propensity for eccentric bowel thickening, heterogenous enhancement and calcification with a p value <0.05.Heterogenous enhancement showed the greatest sensitivity (74%) and calcification the greatest specificity (83%). The other parameters did not show any difference between the two groups. Conclusion: CT features most likely to suggest rectal mucinous carcinoma are heterogenous contrast enhancement, eccentric wall thickening and intratumoral calcification. As mucinous carcinomas follow an aggressive course, if a diagnosis of mucinous carcinoma of the rectum can be suggested on the staging CT, it may influence patient management.

CT Role in Differentiation of Mucinous and non-Mucinous Carcinomas of Rectum