Evaluation of echographic diagnosis of rectal cancer using intrarectal ultrasonic examination

Abstract

Ultrasonic examinations conducted in order to diagnose the depth of invasion and local lymph node metastases of rectal cancer. The intrarectal approach was performed preoperatively in 99 patients with rectal cancer, using either an Olympus-Aloka ultrasonic endoscopeTM (7.5 MHz) or other probes (Aloka, 7.5 MHz, 5 MHz). Through this method, intrapelvic organs were detected clearly, and hypoechoic findings due to tumors were detected in all patients. The normal rectal wall was echogenically divided into five layers, the third layer being the submucosal and the fourth layer being the proper muscle layer. In some cases, the proper muscle layer was divided into three layers in the echogram. In 79 of 88 patients, the diagnosis of depth of invasion, classified into three groups, was possible. Metastatic lymph nodes were shown as a hypoechoic round mass. In 52 of 71 patients proven to have local lymph node metastases in surgical specimens, lymph node metastases were diagnosed preoperatively. Thus, intrarectal ultrasonography provides valuable information concerning the choice of operating methods for rectal cancer.

Rectal carcinoma: Preoperative staging and detection of postoperative local recurrence with transrectal and transvaginal ultrasound

“…In the understaged case, TRUS failed to show perirectal infiltration by the tumor whose histologic examination revealed a large mucinous component. Our findings match those described in the literature [6][7][8][9].…”

“…The accuracy rates of TRUS in preoperative staging of rectal neoplasm vary from 90-96% [7][8][9]. In our series, TRUS detected rectal tumors in all patients and showed exact tumor extension in 33 of 35 cases (accuracy, 94.3%).…”

“…Transrectal ultrasound (TRUS) is proving to be an accurate method for preoperative staging of rectal carcinoma. Rifkin et al [6] in recent studies indicate a sensitivity of 67% and an accuracy of 77% in evaluating perirectal neoplastic infiltration with TRUS; Hildebrandt et al [7] reported an accuracy of 92%, Beynon et al [8] an accuracy of 96%, and Saitoh et al [9] an accuracy of 91%.…”

Preoperative Staging: A Critical Analysis

“…The physical and anatomical description of the two hypoechoic and three hyperechoic layers is extensively discussed elsewhere [9,31,33]. The uT-staging definition of 1985 was later accepted by Saitoh and associates [50], Yamashita and coworkers [59] and many others. Mucosal thickening, preservation of submucosa at lesion centre T2:…”

“…Hildebrandt and Feifel [29] 1985 25 92 Saitoh et al [50] 1986 88 90 73 Di Candio et al [14] 1987 55 91 Accarpio et al [1] 1987 54 94 Beynon et al [6] 1988 89 92 Hildebrandt et al [31] 1988 98 89 Yamashita et al [59] 1988 122 78 Beynon et al [7] 1989 95 83 Rifkin et al [46] 1989 …”