Preoperative staging of rectal carcinoma by endorectal ultrasonography

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2000

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Abstract

Purpose: To evaluate the efficacy and accuracy of endorectal ultrasonography (EUS) in detecting preoperatively rectal wall invasion and nodal involvement in patients with rectal carcinoma. Materials and methods: EUS was applied to 27 patients prediagnosed as having rectal carcinoma by using a 7.5 MHz endorectal transducers with water bag. Sonographic evaluation consisted of estimation of tumour invasion into the rectal wall and adjacent lymph node involvement. All of the patients were operated on with curative intend and the sonographic stage was compared with the postoperative pathologic stage. Results: The accuracy rates of EUS compared with the postoperative pathologic staging were 81%, 70.3% and 59.3% in determining wall invasion, nodal involvement and overall tumour stage, respectively. The most frequent factor leading to false-positive results was the abnormally reactive-hyperplastic lymph nodes which were hypoechoic and larger than 5 mm in diameter. Conclusion: It is concluded that EUS is a moderately reliable imaging method for local tumour staging, mainly due to its relatively high rate of nodal imaging failure.

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