Lower gastrointestinal endoultrasound
SummaryFollowing a brief history of transrectal ultrasonography, the author explains the fundamentals that led to his research on rectal echographic layers and then describes his theory as applied to the anatomical interpretation of these layers. Personal cases of preoperative staging with transrectal echography provide a basis for the critical evaluation of this method and its proposed role in clinical application.
A comparison of computed tomography and endorectal ultrasound in staging rectal cancer
Endorectal ultrasound was used prospectively to stage 85 patients with rectal cancer. All patients had surgical exploration and histological analysis. Demonstration of tumour, extension into perirectal fat and lymph node involvement were evaluated. Eighty-one tumours were successfully imaged by endorectal ultrasound. The results suggest that: (1) endorectal ultrasound is more accurate than CT in detecting the site of tumour; (2) endorectal ultrasound is more accurate than CT in detecting perirectal fat infiltration; (3) endorectal ultrasound is slightly more accurate than CT in detecting level II lymph node involvement.
CT Evaluation of Locally Advanced Carcinoma of the Distal Colon and Rectum
Computed tomography (CT) correctly identified extraluminal extension in carcinoma of the rectum and distal sigmoid in 20 patients who were deemed clinically inoperable because of tumor fixation. All patietns received preoperative radiation therapy and subsequent surgical resection of the tumor. The findings at surgery corroborated the presence and location of tumor extension deep to the wall of the colon. Based on this preliminary data, further investigation into the place of CT in treatment planning of colon carcinomas is indicated.