Study On Intrarectal Filling In With Water In Endoluminal Ultrasonography For Diagnosis Of Rectal Carcinomas

Studyâ… Comparison of Intrarectal Filling-in with Water and Filling in Rubber Sheath with Water in Endoluminal Ultrasonography for Preoperative Staging of Rectal TumorsObjective To compare the value of intrarectal filling-in with water and filling in rubber sheath with water in endoluminal ultrasonography for preoperative staging of rectal tumors.Methods 215 cases of rectal tumors were divided into two groups.120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling-in with water were diagnosed with ultrasonography.The results were compared with corresponding pathologic results for the judgment of their accuracy.Results In the first group,the accuracy for the diagnosis of infiltration depth was 60%(72/120).Diagnoses were missed in 4 cases(3.4%).The staging was underestimated in 11 cases(9.2%) and was overestimated in 33 cases(27.5%).In the second group,the accuracy for the diagnosis of infiltration depth was 73.6%(70/95).The diagnosis was missed in one case (1.1%).Staging was underestimated in 11 cases(11.6%) and was overestimated in 12 cases (12.6%).The difference between the two groups was statistically significant with p<0.05.The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5%in the first group and was 80%in the second.The difference has no statistical significance with p>0.50.Conclusion Intrarectal filling-in with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors,while there is no difference in the diagnosis of metastasis of perirectal lymph nodes. Objective To investigate the endoluminal ultrasonographic characteristics of adenocarcinoma and mucous adenocarcinoma of the rectum.Methods The ultrasonographic characteristics of thirty cases of advanced adenocarcinoma of the rectum and twenty-eight cases of rectal mucous adenocarcinoma were analyzed retrospectively in comparison with their corresponding pathologic images.Results In advanced adenocarcinoma of the rectum,28 cases manifested rough endoluminal surface,of which 19 marked by thickened changes without arrangement of layers, 10 had indistinct arrangement of layers in some areas and one had clear arrangement of layers.In the deepest margin of infiltration,17 cases manifested sentus,homed or knot-like protuberance, while 5 marked by wavy margins,and 8 cases had clear and flat margins.In 25 cases of rectal mucous adenocarcinoma,20 manifested smooth endoluminal surface.With regard to infiltration of tumors to rectal wall,6 cases manifested clear arrangement of layers,while 13 had clear arrangement of layers in part and 6 had no clear arrangement.In the deepest part of infiltration,8 cases manifested slippery and flat margins and 10 manifested wavy margins and 7 had a few sentus,horned or knot-like protuberance locally.According to ultrasonic results of the depth of infiltration to rectal wall in comparison with pathologic findings,25 cases were diagnosed accurately,while in two cases the diagnosis was too shallow and in three cases it was too deep. In rectal mucous adenocarcinoma,10 cases got correct diagnoses and 14 were diagnosed superficially and one got too deep.The accuracy of ultrasonic diagnosis on rectal mucous adenocarcinoma was apparently lower than that of adenocarcinoma and most of the misdiagnoses were too superficial.Conclusion There are different ultrasonographic characteristis of rectal adenocarcinoma and rectal mucous adenocarcinoma,which can be helpful for the typing of rectal carcinoma and avoiding excessively superficial misdiagnosis.