The bowel wall appears of low signal on T1W1 and intermediate signal on T2W1. When distended, the wall thickness of the recto-sigmoid and anal canal should not exceed 5mm and 10mm, respectively. As the bowel wall thickens in the lower rectum, four concentric layers can be discerned. An outside low signal intensity ring represents the outer muscular layer (muscularis propria), within this a layer of higher signal intensity represents the submucosa, this encloses a layer of low signal intensity corresponding to the muscularis mucosa and lamina propria, and centrally lies a high signal intensity layer representing the mucosa. On post-contrast T1W1, the submucosal and mucosal layers enhance but the intervening layer of muscularis mucosa and outer muscular layer do not, permitting differentiation between the layers.
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