Malignant anorectal melanoma: usefulness of fat saturation MR imaging

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An 82-year-old man presented with constipation. On digital examination of the rectum, a bleeding elastic hard mass could be felt near the dentate line. Proctoscopy revealed a 2 cm x 1.5 cm bleeding mass with a small amount of pigmentation. MRI was performed using a 1.5-T superconducting scanner with spin-echo (SE) techniques. On a Tl-weighted image (WI) (TR = 500 ms, TE = 15 ms, Fig. 1 a), the lesion appeared as a slightly high signal intensity, but its margin was unclear. On a fat-saturation Tl-WI (TR = 500 ms, TE = 15 ms, imaging time = 4 min and 16 s, Fig. lc), the lesion had a markedly high signal intensity and could be distinguished from the surrounding area. On a TZWI (Fig. 1 b), the lesion was unclear, but the muscularis propria was not interrupted. Malignant melanoma without invasion to the muscularis propria of the rectum was suspected on imaging analysis.

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