Scialpi M, Zottele F, Niccolini M, Dalla Palma F
Unità Operativa di Radiodiagnostica, USL C5 Centro S. Chiara, Trento.
Radiol Med. 1993 Mar;85(3):203-8.
Transrectal sonography (TRUS) accurately assesses the depth of invasion in the staging of rectal carcinomas. However, the method is limited in the evaluation of upper rectal and highly stenotic rectal cancers. These conditions can be demonstrated in female patients by transvaginal sonography (TVUS) with a 5-MHz convex probe. Conventional TVUS becomes even more accurate when the rectum is distended with water. Twenty-one asymptomatic female patients were examined in a prospective study to assess the value of conventional versus water-distended TVUS. Water improves rectal depiction because it eliminates air and fecal artifacts. In our series, the rectum was demonstrated from anum to rectosigmoid junction in all cases. The whole rectal outline could also be demonstrated. Besides rectal lumen evaluation, the method allowed rectal wall layers and perirectal fat to be detailed. Subsequently, 14 female patients were examined--8 during the preoperative staging and 6 during the follow-up. In preoperative patients, the extent of stenosing rectal cancer and perirectal fat infiltration were assessed; in postoperative patients rectal recurrences were excluded. In conclusion, TVUS with rectal distension by means of water is a new diagnostic procedure which can markedly improve the US imaging of highly stenosing rectal cancers.
经直肠超声检查（TRUS）能准确评估直肠癌分期中的浸润深度。然而，该方法在评估上段直肠癌和高度狭窄性直肠癌时存在局限性。在女性患者中，使用5兆赫凸阵探头的经阴道超声检查（TVUS）可显示这些情况。当直肠用水充盈时，传统TVUS的准确性会更高。一项前瞻性研究对21名无症状女性患者进行了检查，以评估传统TVUS与水充盈TVUS的价值。水可改善直肠显像，因为它消除了气体和粪便伪像。在我们的系列研究中，所有病例均显示了从肛门到直肠乙状结肠交界处的直肠。整个直肠轮廓也能显示出来。除了评估直肠腔，该方法还能详细显示直肠壁层和直肠周围脂肪。随后，对14名女性患者进行了检查——8名在术前分期时检查，6名在随访期间检查。对术前患者评估狭窄性直肠癌的范围和直肠周围脂肪浸润情况；对术后患者排除直肠复发情况。总之，用水充盈直肠的TVUS是一种新的诊断方法，可显著改善高度狭窄性直肠癌的超声成像。
