Ultraschall Med 2005; 26 - OP193
DOI: 10.1055/s-2005-917474

POSSIBILITIES OF ENDOANAL ULTRASOUND EXAMINATION IN DETERMINATING INVASION DEPTH OF THE ANAL TUMORS

LA Mitina 1, VI Kazakevitch 1, IV Droshneva 1, SO Stepanov 1, LA Vashahmadge 2, DV Sidorov 3, VM Khomjakov 2, VV Nemudrov 4, DV Romanov 5
  • 1Radiology
  • 2Sergery
  • 3Surgery, Herzen Moscow Research Institute of Oncology.
  • 4Endoscopy, Department of Radiology in Institute of Professional Development “Medbioekstrem“ MZ RF,
  • 5Radiology, Department of Radiology of Am. MVD, Moscow, Russian Federation

Purpose: Investigation goal was to reveal the possibilities of 3D ultrasound examination in diagnosing anal tumor diffusion level.

Methods and Materials: Ultrasound examination was performed on 20 patients with rectal tumors. 9 patients had anal canal lesions on different stages of radiotherapy. 11 patients had tumors in lower ampullar part of the rectum with advancement to anal canal. All patients had diagnosis confirmed morphologically. 10 patients had squamous-cell cancers, while the other 10 had adenocarcinoma. 7 patients were cured with the radiation therapy, other 13 were subjected to operative treatment.

All patients were examined with proctoscopy, digital rectal examination and ultrasound examination. US examination was performed transrectal in men, transrectal and transvaginal in women. Transvaginal approach has many advantages due to the visualization features of intracavitary convex transducers.

In all cases a 3D image was formed. Examinations were performed on SONOLINE Antares (Siemens) unit. The best visualization of anal canal and lower ampullar part of the rectum was obtained in women with transvaginal approach.

Results: Transrectal ultrasound examination and, sometimes, US examination of the perineum can help to obtain information on tumor localization, growth type (endo-, exo- or mixed), size, mobility, relations with different rectal wall layers and anal structures. Also it gives a possibility to perform aimed biopsy.

After assessing tumor properties mentioned above tumor diffusion level can be evaluated. Transrectal US examination allows visualization of the altered lymph nodes in the perirectal fat. It can be very important for planning specific therapy for patients with highly aggressive squamous-cell rectal cancer. Best 3D image was obtained with transrectal examination using rectal transducer with protective balloon filled with water on it.

Conclusions: Endosonography of the anal canal is an effective method for diagnosing cancer diffusion level. Sensitivity of this method was 88% using either 2D or 3D imaging in women and 80% for 2D and 84% for 3D imaging in men.