Skip to main content
Fig. 5 | Insights into Imaging

Fig. 5

From: Re-staging and follow-up of rectal cancer patients with MR imaging when “Watch-and-Wait” is an option: a practical guide

Fig. 5

The split scar sign is considered present or positive (a) when a thin 1–2 mm regular layer of hypointense “fibrosis” is present at the endoluminal aspect of the tumour bed (corresponding to the fibrosed submucosa), underlined by homogeneous intermediate signal (corresponding to a thickened and partially fibrotic muscularis propria), covered or not by a usually irregular hypointense layer of perirectal fibrosis. In mucinous or mucin-degenerated tumours, the middle intermediate signal intensity layer may be replaced with homogeneously high signal intensity, corresponding to mucin pooling. Whenever the tumour bed is not “organised” in such a layered manner (such as with full thickness “black” scars) or whenever it is but the inner and/or outer “fibrotic walls” are focally breached, the sign should be considered absent/negative (b) [26]

Back to article page