Meyenberger C, Wildi S, Külling D, Bertschinger P, Zala G F, Klotz H P, Krestin G P
Abteilung für Gastroenterologie, Universitätsspital Zürich.
Praxis (Bern 1994). 1996 May 7;85(19):622-31.
Endosonography has become the best available method for local staging of primary rectal cancer and diagnosing recurrent local tumor. The aim of this prospective study is to compare the accuracy of endoscopic ultrasound (EUS), using an echo colonoscope (CF-UM 3, CF-UM 20, Olympus optical) to computed tomography (CT), body coil magnetic resonance imaging (MRI) and endorectal coil magnetic resonance imaging (EMRI).
From February 1991 to July 1993 90 patients with primary rectosigmoidal tumors (n = 32: 9 women, 23 men, mean age 68 years [range 37 to 84]) or follow-up examinations for recurrent local cancer (patients: n = 58, examinations: n = 93; 41 women, 52 men, mean age 61 years [range 31 to 84]) were investigated. The results of preoperative examinations were compared to histopathological findings regarding T and N stages.
In T staging, accuracy of EUS (78%) was superior to CT (50%) and equivalent to both MRI (75%) and EMRI (80%). The accuracy of EUS (84%) in assessing transmural tumor infiltration was superior to CT, MRT and EMRT (50%, 75% and 80%, resp.); however, CT (77%) and MRI (86%) were more accurate than EUS (64%) and EMRI (33%) in assessing N stages. Recurrent local cancer was found in 22 patients. All but one were detected by EUS. Sensitivity, specificity and accuracy in follow-up examinations for recurrent disease for EUS were 95%, 94% and 95%, for CT 75%, 73% and 74%, for MRI 57%, 100% and 70%, and for EMRI 83%, 100% and 90% resp.
Endoscopic ultrasound proved to be a safe and accurate method of preoperative staging and early diagnosis of recurrent rectal cancer and was superior or at least equivalent to CT, MRI and EMRI.
内镜超声已成为原发性直肠癌局部分期及诊断局部复发性肿瘤的最佳可用方法。本前瞻性研究的目的是比较使用超声结肠镜（CF-UM 3、CF-UM 20，奥林巴斯光学）的内镜超声（EUS）与计算机断层扫描（CT）、体部线圈磁共振成像（MRI）及直肠内线圈磁共振成像（EMRI）的准确性。
1991年2月至1993年7月，对90例原发性直肠乙状结肠肿瘤患者（n = 32：9例女性，23例男性，平均年龄68岁[范围37至84岁]）或局部复发性癌症的随访检查患者（患者：n = 58，检查：n = 93；41例女性，52例男性，平均年龄61岁[范围31至84岁]）进行了研究。将术前检查结果与关于T和N分期的组织病理学结果进行比较。
在T分期中，EUS的准确性（78%）优于CT（50%），与MRI（75%）和EMRI（80%）相当。EUS评估透壁肿瘤浸润的准确性（84%）优于CT、MRT和EMRT（分别为50%、75%和80%）；然而，在评估N分期方面，CT（77%）和MRI（86%）比EUS（64%）和EMRI（33%）更准确。22例患者发现局部复发性癌症。除1例患者外，所有病例均由EUS检测到。EUS对复发性疾病随访检查的敏感性、特异性和准确性分别为95%、94%和95%，CT分别为75%、73%和74%，MRI分别为57%、100%和70%，EMRI分别为83%、100%和90%。
内镜超声被证明是术前分期及早期诊断复发性直肠癌的一种安全且准确的方法，并且优于或至少等同于CT、MRI和EMRI。
