Endoluminal Ultrasound

  • Donald G. Kim
  • W. Douglas Wong


Evaluation of the anal canal and rectum has traditionally relied on digital examination, anoscopy, and rigid or flexible proctosigmoidoscopy. The introduction of imaging methods, particularly endoluminal ultrasonography, has brought a greater degree of objectivity to the evaluation of the anorectum.


  1. 1.
    Wild JJ, Reid JM. Diagnostic use of ultrasound. Br J Phys Med. 1956;19(11):248–57.PubMedGoogle Scholar
  2. 2.
    Dragsted J, Gammelgaard J. Endoluminal ultrasonic scanning in the evaluation of rectal cancer: a preliminary report of 13 cases. Gastrointest Radiol. 1983;8(4):367–9.PubMedGoogle Scholar
  3. 3.
    Hildebrandt U, Feifel G. Preoperative staging of rectal ­cancer by intrarectal ultrasound. Dis Colon Rectum. 1985;28(1):42–6.PubMedGoogle Scholar
  4. 4.
    Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. Colon and rectum. AJCC cancer staging manual. 7th ed. New York: Springer; 2009.Google Scholar
  5. 5.
    Beynon J, Foy DM, Temple LN, Channer JL, Virjee J, Mortensen NJ. The endosonic appearances of normal colon and rectum. Dis Colon Rectum. 1986;29(12):810–3.PubMedGoogle Scholar
  6. 6.
    Deen KI, Madoff RD, Wong WD. Preoperative staging of rectal neoplasms with endorectal ultrasonography. Semin Colon Rectal Surg. 1995;6:78–85.Google Scholar
  7. 7.
    Garcia-Aguilar J, Pollack J, Lee S-H, et al. Accuracy of endorectal ultrasonography in preoperative staging of rectal tumors. Dis Colon Rectum. 2002;45(1):10–5.PubMedGoogle Scholar
  8. 8.
    Pikarsky A, Wexner S, Lebensart P, et al. The use of rectal ultrasound for the correct diagnosis and treatment of rectal villous tumors. Am J Surg. 2000;179(4):261–5.PubMedGoogle Scholar
  9. 9.
    Worrell S, Horvath K, Blakemore T, Flum D. Endorectal ultrasound detection of focal carcinoma within rectal adenomas. Am J Surg. 2004;187(5):625–9. discussion 629.PubMedGoogle Scholar
  10. 10.
    Kim DG, Madoff RD. Transanal treatment of rectal cancer: ablative methods and open resection. Semin Surg Oncol. 1998;15(2):101–13.PubMedGoogle Scholar
  11. 11.
    Beynon J, Mortensen NJ, Foy DM, Channer JL, Rigby H, Virjee J. Preoperative assessment of mesorectal lymph node involvement in rectal cancer. Br J Surg. 1989;76(3):276–9.PubMedGoogle Scholar
  12. 12.
    Rifkin MD, Ehrlich SM, Marks G. Staging of rectal carcinoma: prospective comparison of endorectal US and CT. Radiology. 1989;170(2):319–22.PubMedGoogle Scholar
  13. 13.
    Starck M, Bohe M, Fork FT, Lindstrom C, Sjoberg S. Endoluminal ultrasound and low-field magnetic resonance imaging are superior to clinical examination in the preoperative staging of rectal cancer. Eur J Surg. 1995;161(11):841–5.PubMedGoogle Scholar
  14. 14.
    Milsom JW, Graffner H. Intrarectal ultrasonography in rectal cancer staging and in the evaluation of pelvic disease. Clinical uses of intrarectal ultrasound. Ann Surg. 1990;212(5):602–6.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Rafaelsen SR, Kronborg O, Fenger C. Digital rectal examination and transrectal ultrasonography in staging of rectal cancer. A prospective, blind study. Acta Radiol. 1994;35(3):300–4.PubMedGoogle Scholar
  16. 16.
    Kwok H, Bissett IP, Hill GL. Preoperative staging of rectal cancer. Int J Colorectal Dis. 2000;15(1):9–20.PubMedGoogle Scholar
  17. 17.
    Pappalardo G, Reggio D, Frattaroli FM, et al. The value of endoluminal ultrasonography and computed tomography in the staging of rectal cancer: a preliminary study. J Surg Oncol. 1990;43(4):219–22.PubMedGoogle Scholar
  18. 18.
    Puli SR, Reddy JB, Bechtold ML, Choudhary A, Antillon MR, Brugge WR. Accuracy of endoscopic ultrasound to diagnose nodal invasion by rectal cancers: a meta-analysis and systematic review. Ann Surg Oncol. 2009;16(5):1255–65.PubMedGoogle Scholar
  19. 19.
    Thaler W, Watzka S, Martin F, et al. Preoperative staging of rectal cancer by endoluminal ultrasound vs. magnetic resonance imaging. Preliminary results of a prospective, comparative study. Dis Colon Rectum. 1994;37(12):1189–93.PubMedGoogle Scholar
  20. 20.
    Bipat S, Glas AS, Slors FJM, Zwinderman AH, Bossuyt PMM, Stoker J. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging – a meta-analysis. Radiology. 2004;232(3):773–83.PubMedGoogle Scholar
  21. 21.
    Kim NK, Kim MJ, Yun SH, Sohn SK, Min JS. Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer. Dis Colon Rectum. 1999;42(6):770–5.PubMedGoogle Scholar
  22. 22.
    Dinter DJ, Hofheinz R-D, Hartel M, Kaehler GFAB, Neff W, Diehl SJ. Preoperative staging of rectal tumors: comparison of endorectal ultrasound, hydro-CT, and high-resolution endorectal MRI. Onkologie. 2008;31(5):230–5.PubMedGoogle Scholar
  23. 23.
    Tio TL, Tytgat GN. Endoscopic ultrasonography in analysing peri-intestinal lymph node abnormality. Preliminary results of studies in vitro and in vivo. Scand J Gastroenterol Suppl. 1986;123:158–63.PubMedGoogle Scholar
  24. 24.
    Hildebrandt U, Klein T, Feifel G, Schwarz HP, Koch B, Schmitt RM. Endosonography of pararectal lymph nodes. In vitro and in vivo evaluation. Dis Colon Rectum. 1990;33(10):863–8.PubMedGoogle Scholar
  25. 25.
    Herrera-Ornelas L, Justiniano J, Castillo N, Petrelli NJ, Stulc JP, Mittelman A. Metastases in small lymph nodes from colon cancer. Arch Surg. 1987;122(11):1253–6.PubMedGoogle Scholar
  26. 26.
    Katsura Y, Yamada K, Ishizawa T, Yoshinaka H, Shimazu H. Endorectal ultrasonography for the assessment of wall invasion and lymph node metastasis in rectal cancer. Dis Colon Rectum. 1992;35(4):362–8.PubMedGoogle Scholar
  27. 27.
    Akasu T, Sugihara K, Moriya Y, Fujita S. Limitations and pitfalls of transrectal ultrasonography for staging of rectal cancer. Dis Colon Rectum. 1997;40 Suppl 10:S10–5.PubMedGoogle Scholar
  28. 28.
    Sunouchi K, Sakaguchi M, Higuchi Y, Namiki K, Muto T. Small spot sign of rectal carcinoma by endorectal ultrasonography: histologic relation and clinical impact on postoperative recurrence. Dis Colon Rectum. 1998;41(5):649–53.PubMedGoogle Scholar
  29. 29.
    Sunouchi K, Sakaguchi M, Higuchi Y, Namiki K, Muto T. Limitation of endorectal ultrasonography: what does a low lesion more than 5 mm in size correspond to histologically? Dis Colon Rectum. 1998;41(6):761–4.PubMedGoogle Scholar
  30. 30.
    Saitoh N, Okui K, Sarashina H, Suzuki M, Arai T, Nunomura M. Evaluation of echographic diagnosis of rectal cancer using intrarectal ultrasonic examination. Dis Colon Rectum. 1986;29(4):234–42.PubMedGoogle Scholar
  31. 31.
    Holdsworth PJ, Johnston D, Chalmers AG, et al. Endoluminal ultrasound and computed tomography in the staging of rectal cancer. Br J Surg. 1988;75(10):1019–22.PubMedGoogle Scholar
  32. 32.
    Beynon J. An evaluation of the role of rectal endosonography in rectal cancer. Ann R Coll Surg Engl. 1989;71(2):131–9.PubMedPubMedCentralGoogle Scholar
  33. 33.
    Glaser F, Schlag P, Herfarth C. Endorectal ultrasonography for the assessment of invasion of rectal tumours and lymph node involvement. Br J Surg. 1990;77(8):883–7.PubMedGoogle Scholar
  34. 34.
    Jochem RJ, Reading CC, Dozois RR, Carpenter HA, Wolff BG, Charboneau JW. Endorectal ultrasonographic staging of rectal carcinoma. Mayo Clin Proc. 1990;65(12):1571–7.PubMedGoogle Scholar
  35. 35.
    Orrom WJ, Wong WD, Rothenberger DA, Jensen LL, Goldberg SM. Endorectal ultrasound in the preoperative ­staging of rectal tumors. A learning experience. Dis Colon Rectum. 1990;33(8):654–9.PubMedGoogle Scholar
  36. 36.
    Glaser F, Kuntz C, Schlag P, Herfarth C. Endorectal ultrasound for control of preoperative radiotherapy of rectal cancer. Ann Surg. 1993;217(1):64–71.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Herzog U, von Flue M, Tondelli P, Schuppisser JP. How accurate is endorectal ultrasound in the preoperative staging of rectal cancer? Dis Colon Rectum. 1993;36(2):127–34.PubMedGoogle Scholar
  38. 38.
    Adams DR, Blatchford GJ, Lin KM, Ternent CA, Thorson AG, Christensen MA. Use of preoperative ultrasound staging for treatment of rectal cancer. Dis Colon Rectum. 1999;42(2):159–66.PubMedGoogle Scholar
  39. 39.
    Marusch F, Koch A, Schmidt U, et al. Routine use of transrectal ultrasound in rectal carcinoma: results of a prospective multicenter study. Endoscopy. 2002;34(5):385–90.PubMedGoogle Scholar
  40. 40.
    Kauer WKH, Prantl L, Dittler HJ, Siewert JR. The value of endosonographic rectal carcinoma staging in routine diagnostics: a 10-year analysis. Surg Endosc. 2004;18(7):1075–8.PubMedGoogle Scholar
  41. 41.
    Solomon MJ, McLeod RS. Endoluminal transrectal ultrasonography: accuracy, reliability, and validity. Dis Colon Rectum. 1993;36(2):200–5.PubMedGoogle Scholar
  42. 42.
    Kruskal JB, Kane RA, Sentovich SM, Longmaid HE. Pitfalls and sources of error in staging rectal cancer with endorectal us. Radiographics. 1997;17(3):609–26.PubMedGoogle Scholar
  43. 43.
    Zammit M, Jenkins JT, Urie A, O’Dwyer PJ, Molloy RG. A technically difficult endorectal ultrasound is more likely to be inaccurate. Colorectal Dis. 2005;7(5):486–91.PubMedGoogle Scholar
  44. 44.
    Goertz RS, Fein M, Sailer M. Impact of biopsy on the accuracy of endorectal ultrasound staging of rectal tumors. Dis Colon Rectum. 2008;51(7):1125–9.PubMedGoogle Scholar
  45. 45.
    Bernini A, Deen KI, Madoff RD, Wong WD. Preoperative adjuvant radiation with chemotherapy for rectal cancer: its impact on stage of disease and the role of endorectal ultrasound. Ann Surg Oncol. 1996;3(2):131–5.PubMedGoogle Scholar
  46. 46.
    Fleshman JW, Myerson RJ, Fry RD, Kodner IJ. Accuracy of transrectal ultrasound in predicting pathologic stage of rectal cancer before and after preoperative radiation therapy. Dis Colon Rectum. 1992;35(9):823–9.PubMedGoogle Scholar
  47. 47.
    Huh JW, Park YA, Jung EJ, Lee KY, Sohn S-K. Accuracy of endorectal ultrasonography and computed tomography for restaging rectal cancer after preoperative chemoradiation. J Am Coll Surg. 2008;207(1):7–12.PubMedGoogle Scholar
  48. 48.
    Maretto I, Pomerri F, Pucciarelli S, et al. The potential of restaging in the prediction of pathologic response after preoperative chemoradiotherapy for rectal cancer. Ann Surg Oncol. 2007;14(2):455–61.PubMedGoogle Scholar
  49. 49.
    Rau B, Hunerbein M, Barth C, et al. Accuracy of endorectal ultrasound after preoperative radiochemotherapy in locally advanced rectal cancer. Surg Endosc. 1999;13(10):980–4.PubMedGoogle Scholar
  50. 50.
    Williamson PR, Hellinger MD, Larach SW, Ferrara A. Endorectal ultrasound of T3 and T4 rectal cancers after preoperative chemoradiation. Dis Colon Rectum. 1996;39(1):45–9.PubMedGoogle Scholar
  51. 51.
    Brown CL, Ternent CA, Thorson AG, et al. Response to preoperative chemoradiation in stage II and III rectal cancer. Dis Colon Rectum. 2003;46(9):1189–93.PubMedGoogle Scholar
  52. 52.
    Radovanovic Z, Breberina M, Petrovic T, Golubovic A, Radovanovic D. Accuracy of endorectal ultrasonography in staging locally advanced rectal cancer after preoperative chemoradiation. Surg Endosc. 2008;22(11):2412–5.PubMedGoogle Scholar
  53. 53.
    Sagar PM, Pemberton JH. Surgical management of locally recurrent rectal cancer. Br J Surg. 1996;83(3):293–304.PubMedGoogle Scholar
  54. 54.
    Michelassi F, Vannucci L, Ayala JJ, Chappel R, Goldberg R, Block GE. Local recurrence after curative resection of colorectal adenocarcinoma. Surgery. 1990;108(4):787–92. discussion 792–783.PubMedGoogle Scholar
  55. 55.
    Beynon J, Mortensen NJ, Foy DM, Channer JL, Rigby H, Virjee J. The detection and evaluation of locally recurrent rectal cancer with rectal endosonography. Dis Colon Rectum. 1989;32(6):509–17.PubMedGoogle Scholar
  56. 56.
    de Anda EH, Lee S-H, Finne CO, Rothenberger DA, Madoff RD, Garcia-Aguilar J. Endorectal ultrasound in the follow-up of rectal cancer patients treated by local excision or radical surgery. Dis Colon Rectum. 2004;47(6):818–24.PubMedGoogle Scholar
  57. 57.
    Mascagni D, Corbellini L, Urciuoli P, Di Matteo G. Endoluminal ultrasound for early detection of local recurrence of rectal cancer. Br J Surg. 1989;76(11):1176–80.PubMedGoogle Scholar
  58. 58.
    Ramirez JM, Mortensen NJ, Takeuchi N, Humphreys MM. Endoluminal ultrasonography in the follow-up of patients with rectal cancer. Br J Surg. 1994;81(5):692–4.PubMedGoogle Scholar
  59. 59.
    Rotondano G, Esposito P, Pellecchia L, Novi A, Romano G. Early detection of locally recurrent rectal cancer by endosonography. Br J Radiol. 1997;70(834):567–71.PubMedGoogle Scholar
  60. 60.
    Morken JJ, Baxter NN, Madoff RD, Finne III CO. Endorectal ultrasound-directed biopsy: a useful technique to detect local recurrence of rectal cancer. Int J Colorectal Dis. 2006;21(3):258–64.PubMedGoogle Scholar
  61. 61.
    Meyenberger C, Wildi S, Kulling D, et al. Tumor staging and follow-up care in rectosigmoid carcinoma: colonoscopic endosonography compared to CT, MRI and endorectal MRI. Praxis (Bern 1994). 1996;85(19):622–31.Google Scholar
  62. 62.
    Tjandra JJ, Milsom JW, Stolfi VM, et al. Endoluminal ultrasound defines anatomy of the anal canal and pelvic floor. Dis Colon Rectum. 1992;35(5):465–70.PubMedGoogle Scholar
  63. 63.
    Rieger N, Tjandra J, Solomon M. Endoanal and endorectal ultrasound: applications in colorectal surgery. ANZ J Surg. 2004;74(8):671–5.PubMedGoogle Scholar
  64. 64.
    Sentovich SM, Wong WD, Blatchford GJ. Accuracy and reliability of transanal ultrasound for anterior anal sphincter injury. Dis Colon Rectum. 1998;41(8):1000–4.PubMedGoogle Scholar
  65. 65.
    Tjandra JJ, Milsom JW, Schroeder T, Fazio VW. Endoluminal ultrasound is preferable to electromyography in mapping anal sphincteric defects. Dis Colon Rectum. 1993;36(7):689–92.PubMedGoogle Scholar
  66. 66.
    Mellgren A, Jensen LL, Zetterstrom JP, Wong WD, Hofmeister JH, Lowry AC. Long-term cost of fecal incontinence sec‑ond­ary to obstetric injuries. Dis Colon Rectum. 1999;42(7):857–65. discussion 865–857.PubMedGoogle Scholar
  67. 67.
    Allen RE, Hosker GL, Smith AR, Warrell DW. Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol. 1990;97(9):770–9.PubMedGoogle Scholar
  68. 68.
    Sultan AH, Kamm MA, Hudson CN, Thomas JM, Bartram CI. Anal-sphincter disruption during vaginal delivery. N Engl J Med. 1993;329(26):1905–11.PubMedGoogle Scholar
  69. 69.
    Poen AC, Felt-Bersma RJ, Strijers RL, Dekker GA, Cuesta MA, Meuwissen SG. Third-degree obstetric perineal tear: long-term clinical and functional results after primary repair. Br J Surg. 1998;85(10):1433–8.PubMedGoogle Scholar
  70. 70.
    Sorensen M, Tetzschner T, Rasmussen OO, Bjarnesen J, Christiansen J. Sphincter rupture in childbirth. Br J Surg. 1993;80(3):392–4.PubMedGoogle Scholar
  71. 71.
    Tetzschner T, Sorensen M, Lose G, Christiansen J. Anal and urinary incontinence in women with obstetric anal sphincter rupture. Br J Obstet Gynaecol. 1996;103(10):1034–40.PubMedGoogle Scholar
  72. 72.
    Burnett SJ, Spence-Jones C, Speakman CT, Kamm MA, Hudson CN, Bartram CI. Unsuspected sphincter damage following childbirth revealed by anal endosonography. Br J Radiol. 1991;64(759):225–7.PubMedGoogle Scholar
  73. 73.
    Sultan AH, Kamm MA, Hudson CN, Bartram CI. Effect of pregnancy on anal sphincter morphology and function. Int J Colorectal Dis. 1993;8(4):206–9.PubMedGoogle Scholar
  74. 74.
    Varma A, Gunn J, Gardiner A, Lindow SW, Duthie GS. Obstetric anal sphincter injury: prospective evaluation of incidence. Dis Colon Rectum. 1999;42(12):1537–43.PubMedGoogle Scholar
  75. 75.
    Willis S, Faridi A, Schelzig S, et al. Childbirth and incontinence: a prospective study on anal sphincter morphology and function before and early after vaginal delivery. Langenbecks Arch Surg. 2002;387(2):101–7.PubMedGoogle Scholar
  76. 76.
    Zetterstrom J, Mellgren A, Jensen LL, et al. Effect of delivery on anal sphincter morphology and function. Dis Colon Rectum. 1999;42(10):1253–60.PubMedGoogle Scholar
  77. 77.
    Tsang CB, Madoff RD, Wong WD, et al. Anal sphincter integrity and function influences outcome in rectovaginal fistula repair. Dis Colon Rectum. 1998;41(9):1141–6.PubMedGoogle Scholar
  78. 78.
    Deen KI, Kumar D, Williams JG, Olliff J, Keighley MR. Anal sphincter defects. Correlation between endoanal ultrasound and surgery. Ann Surg. 1993;218(2):201–5.PubMedPubMedCentralGoogle Scholar
  79. 79.
    Falk PM, Blatchford GJ, Cali RL, Christensen MA, Thorson AG. Transanal ultrasound and manometry in the evaluation of fecal incontinence. Dis Colon Rectum. 1994;37(5):468–72.PubMedGoogle Scholar
  80. 80.
    Farouk R, Bartolo DC. The use of endoluminal ultrasound in the assessment of patients with faecal incontinence. J R Coll Surg Edinb. 1994;39(5):312–8.PubMedGoogle Scholar
  81. 81.
    Titi MA, Jenkins JT, Urie A, Molloy RG. Perineum compression during EAUS enhances visualization of anterior anal sphincter defects. Colorectal Dis. 2009;11(6):625–30.PubMedGoogle Scholar
  82. 82.
    Zetterstrom JP, Mellgren A, Madoff RD, Kim DG, Wong WD. Perineal body measurement improves evaluation of anterior sphincter lesions during endoanal ultrasonography. Dis Colon Rectum. 1998;41(6):705–13.PubMedGoogle Scholar
  83. 83.
    deVries PA, Pena A. Posterior sagittal anorectoplasty. J Pediatr Surg. 1982;17(5):638–43.PubMedGoogle Scholar
  84. 84.
    Jones NM, Humphreys MS, Goodman TR, Sullivan PB, Grant HW. The value of anal endosonography compared with magnetic resonance imaging following the repair of anorectal malformations. Pediatr Radiol. 2003;33(3):183–5.PubMedGoogle Scholar
  85. 85.
    Simmang CL, Huber Jr PJ, Guzzetta P, Crockett J, ­Martinez R. Posterior sagittal anorectoplasty in adults: secondary repair for persistent incontinence in patients with anorectal malformations. Dis Colon Rectum. 1999;42(8):1022–7.PubMedGoogle Scholar
  86. 86.
    Emblem R, Morkrid L, Bjornland K. Anal endosonography is useful for postoperative assessment of anorectal malformations. J Pediatr Surg. 2007;42(9):1549–54.PubMedGoogle Scholar
  87. 87.
    Gilliland R, Altomare DF, Moreira Jr H, Oliveira L, Gilliland JE, Wexner SD. Pudendal neuropathy is predictive of failure following anterior overlapping sphincteroplasty. Dis Colon Rectum. 1998;41(12):1516–22.PubMedGoogle Scholar
  88. 88.
    Donnelly V, Fynes M, Campbell D, Johnson H, O’Connell PR, O’Herlihy C. Obstetric events leading to anal sphincter damage. Obstet Gynecol. 1998;92(6):955–61.PubMedGoogle Scholar
  89. 89.
    Solomon MJ, McLeod RS, O’Connor BI, Cohen Z. Assessment of peripouch inflammation after ileoanal anastomosis using endoluminal ultrasonography. Dis Colon Rectum. 1995;38(2):182–7.PubMedGoogle Scholar
  90. 90.
    Cataldo PA, Senagore A, Luchtefeld MA. Intrarectal ultrasound in the evaluation of perirectal abscesses. Dis Colon Rectum. 1993;36(6):554–8.PubMedGoogle Scholar
  91. 91.
    Deen KI, Williams JG, Hutchinson R, Keighley MR, Kumar D. Fistulas in ano: endoanal ultrasonographic assessment assists decision making for surgery. Gut. 1994;35(3):391–4.PubMedPubMedCentralGoogle Scholar
  92. 92.
    Law PJ, Talbot RW, Bartram CI, Northover JM. Anal endosonography in the evaluation of perianal sepsis and fistula in ano. Br J Surg. 1989;76(7):752–5.PubMedGoogle Scholar
  93. 93.
    Lengyel AJ, Hurst NG, Williams JG. Pre-operative assessment of anal fistulas using endoanal ultrasound. Colorectal Dis. 2002;4(6):436–40.PubMedGoogle Scholar
  94. 94.
    Cheong DM, Nogueras JJ, Wexner SD, Jagelman DG. Anal endosonography for recurrent anal fistulas: image enhancement with hydrogen peroxide. Dis Colon Rectum. 1993;36(12):1158–60.PubMedGoogle Scholar
  95. 95.
    Poen AC, Felt-Bersma RJ, Eijsbouts QA, Cuesta MA, Meuwissen SG. Hydrogen peroxide-enhanced transanal ultrasound in the assessment of fistula-in-ano. Dis Colon Rectum. 1998;41(9):1147–52.PubMedGoogle Scholar
  96. 96.
    Navarro-Luna A, Garcia-Domingo MI, Rius-Macias J, Marco-Molina C. Ultrasound study of anal fistulas with hydrogen peroxide enhancement. Dis Colon Rectum. 2004;47(1):108–14.PubMedGoogle Scholar
  97. 97.
    Cho DY. Endosonographic criteria for an internal opening of fistula-in-ano. Dis Colon Rectum. 1999;42(4):515–8.PubMedGoogle Scholar
  98. 98.
    Ortiz H, Marzo J, Jimenez G, DeMiguel M. Accuracy of hydrogen peroxide-enhanced ultrasound in the identification of internal openings of anal fistulas. Colorectal Dis. 2002;4(4):280–3.PubMedGoogle Scholar
  99. 99.
    Toyonaga T, Tanaka Y, Song JF, et al. Comparison of accuracy of physical examination and endoanal ultrasonography for preoperative assessment in patients with acute and chronic anal fistula. Tech Coloproctol. 2008;12(3):217–23.PubMedGoogle Scholar
  100. 100.
    Sahni VA, Ahmad R, Burling D. Which method is best for imaging of perianal fistula? Abdom Imaging. 2008;33(1):26–30.PubMedGoogle Scholar
  101. 101.
    Goldman S, Norming U, Svensson C, Glimelius B. Transanorectal ultrasonography in the staging of anal epidermoid carcinoma. Int J Colorectal Dis. 1991;6(3):152–7.PubMedGoogle Scholar
  102. 102.
    Herzog U, Boss M, Spichtin HP. Endoanal ultrasonography in the follow-up of anal carcinoma. Surg Endosc. 1994;8(10):1186–9.PubMedGoogle Scholar
  103. 103.
    Roseau G, Palazzo L, Colardelle P, Chaussade S, Couturier D, Paolaggi JA. Endoscopic ultrasonography in the staging and follow-up of epidermoid carcinoma of the anal canal. Gastrointest Endosc. 1994;40(4):447–50.PubMedGoogle Scholar
  104. 104.
    Giovannini M, Bardou VJ, Barclay R, et al. Anal carcinoma: prognostic value of endorectal ultrasound (ERUS). Results of a prospective multicenter study. Endoscopy. 2001;33(3):231–6.PubMedGoogle Scholar
  105. 105.
    Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC cancer staging manual. 7th ed. New York: Springer; 2009. p. 165–74.Google Scholar
  106. 106.
    Tarantino D, Bernstein MA. Endoanal ultrasound in the staging and management of squamous-cell carcinoma of the anal canal: potential implications of a new ultrasound staging system. Dis Colon Rectum. 2002;45(1):16–22.PubMedGoogle Scholar
  107. 107.
    Hunerbein M, Pegios W, Rau B, Vogl TJ, Felix R, Schlag PM. Prospective comparison of endorectal ultrasound, three-dimensional endorectal ultrasound, and endorectal MRI in the preoperative evaluation of rectal tumors. Preliminary results. Surg Endosc. 2000;14(11):1005–9.PubMedGoogle Scholar
  108. 108.
    Kim JC, Kim HC, Yu CS, et al. Efficacy of 3-dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging. Am J Surg. 2006;192(1):89–97.PubMedGoogle Scholar
  109. 109.
    West RL, Dwarkasing S, Briel JW, et al. Can three-dimensional endoanal ultrasonography detect external anal sphincter atrophy? A comparison with endoanal magnetic resonance imaging. Int J Colorectal Dis. 2005;20(4):328–33.PubMedGoogle Scholar
  110. 110.
    Gold DM, Bartram CI, Halligan S, Humphries KN, Kamm MA, Kmiot WA. Three-dimensional endoanal sonography in assessing anal canal injury. Br J Surg. 1999;86(3):365–70.PubMedGoogle Scholar
  111. 111.
    West RL, Dwarkasing S, Felt-Bersma RJ, et al. Hydrogen peroxide-enhanced three-dimensional endoanal ultrasonography and endoanal magnetic resonance imaging in evaluating perianal fistulas: agreement and patient preference. Eur J Gastroenterol Hepatol. 2004;16(12):1319–24.PubMedGoogle Scholar
  112. 112.
    Buchanan GN, Bartram CI, Williams AB, Halligan S, Cohen CRG. Value of hydrogen peroxide enhancement of three-dimensional endoanal ultrasound in fistula-in-ano. Dis Colon Rectum. 2005;48(1):141–7.PubMedGoogle Scholar

Copyright information

© ASCRS (American Society of Colon and Rectal Surgeons) 2011

Authors and Affiliations

  • Donald G. Kim
    • 1
    • 2
  • W. Douglas Wong
    • 3
    • 4
  1. 1.Department of SurgeryMichigan State University College of Human MedicineLansingUSA
  2. 2.Ferguson ClinicGrand RapidsUSA
  3. 3.Weill Medical College of Cornell UniversityNew YorkUSA
  4. 4.Memorial Sloan-Kettering Cancer CenterNew YorkUSA

Personalised recommendations