Skip to main content
Log in

The role of three-dimensional endoluminal ultrasound imaging in the evaluation of anorectal diseases: a review

  • Review
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The authors conducted a review of the available English literature to evaluate the advantages of three-dimensional ultrasound for assessing anorectal pathology, to provide a state-of-the-art approach, and to compare this technique with conventional endoluminal ultrasound and other imaging methods.

Methods

All studies describing results obtained with three-dimensional ultrasound in the evaluation of anorectal pathologies, both alone and compared with other techniques, were selected.

Results

Since 1996, 32 articles have been published. In tumor staging, specific data derived by three-dimensional reconstruction for the assessment of T invasion and nodal involvement were more accurate than endoluminal ultrasound and computed tomography. For evaluating perianal sepsis, the detection of secondary fistula tracts and fluid collections and the location of internal openings were superior to endoanal magnetic resonance imaging. In the evaluation of anal incontinence, the results for sphincter defects were similar to those obtained with endoanal magnetic resonance imaging.

Conclusion

Analysis of the literature confirmed that three-dimensional ultrasound is a valuable technique for assessing anorectal disorders, facilitating the interpretation of the images obtained, and providing additional data that in many cases have changed the operative approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Saclarides TJ (1998) Endorectal ultrasound. Surg Clin North Am 78:237–249

    Article  PubMed  CAS  Google Scholar 

  2. Schaffzin DM, Wong WD (2004) Surgeon-performed ultrasound: endorectal ultrasound. Surg Clin North Am 84:1127–1149

    Article  PubMed  Google Scholar 

  3. Engin G (2006) Endosonographic imaging of anorectal diseases. J Ultrasound Med 25:57–73

    PubMed  Google Scholar 

  4. Konerding MA, Dzemali O, Gaumann A, Malkusch W, Eckardt VF (1999) Correlation of endoanal sonography with cross-sectional anatomy of the anal sphincter. Gastrointest Endosc 50:804–810

    Article  PubMed  CAS  Google Scholar 

  5. Bollard RC, Gardiner A, Lindow S, Phillips K, Duthie GS (2002) Normal female anal sphincter: difficulties in interpretation explained. Dis Colon Rectum 45:171–175

    Article  PubMed  CAS  Google Scholar 

  6. Regadas FS, Murad-Regadas SM, Lima DM, Silva FR, Barreto RG, Souza MH, Filho FS (2007) Anal canal anatomy showed by three-dimensional anorectal ultrasonography. Surg Endosc 21:2207–2211

    Article  PubMed  Google Scholar 

  7. Reisinger E, Stummvoll W (2006) Visualization of the endopelvic fascia by transrectal three-dimensional ultrasound. Int Urogynecol J Pelvic Floor Dysfunct 17:165–169

    Article  PubMed  Google Scholar 

  8. Williams AB, Bartram CI, Halligan S, Marshall MM, Nicholls RJ, Kmiot WA (2002) Endosonographic anatomy of the normal anal canal compared with endocoil magnetic resonance imaging. Dis Colon Rectum 45:176–183

    Article  PubMed  CAS  Google Scholar 

  9. Gregory WT, Boyles SH, Simmons K, Corcoran A, Clark AL (2006) External anal sphincter volume measurements using 3-dimensional endoanal ultrasound. Am J Obstet Gynecol 194:1243–1248

    Article  PubMed  Google Scholar 

  10. Gold DM, Bartram CI, Halligan S, Humphries KN, Kamm MA, Kmiot WA (1999) Three-dimensional endoanal sonography in assessing anal canal injury. Br J Surg 86:365–370

    Article  PubMed  CAS  Google Scholar 

  11. Gosselink MP, West RL, Kuipers EJ, Hansen BE, Schouten WR (2005) Integrity of the anal sphincters after pouch–anal anastomosis: evaluation with three-dimensional endoanal ultrasonography. Dis Colon Rectum 48:1728–1735

    Article  PubMed  Google Scholar 

  12. West RL, Dwarkasing S, Briel JW, Hansen BE, Hussain SM, Schouten WR, Kuipers EJ (2005) Can three-dimensional endoanal ultrasonography detect external anal sphincter atrophy? A comparison with endoanal magnetic resonance imaging. Int J Colorectal Dis 20:328–333

    Article  PubMed  CAS  Google Scholar 

  13. Briel JW, Stoker J, Rociu E, Laméris JS, Hop WC, Schouten WR (1999) External anal sphincter atrophy on endoanal magnetic resonance imaging adversely affects continence after sphincteroplasty. Br J Surg 86:1322–1327

    Article  PubMed  CAS  Google Scholar 

  14. Williams AB, Bartram CI, Modhwadia D, Nicholls T, Halligan S, Kamm MA, Nicholls RJ, Kmiot WA (2001) Endocoil magnetic resonance imaging quantification of external anal sphincter atrophy. Br J Surg 88:853–859

    Article  PubMed  CAS  Google Scholar 

  15. Cazemier M, Terra MP, Stoker J, de Lange-de Klerk ES, Boeckxstaens GE, Mulder CJ, Felt-Bersma RJ (2006) Atrophy and defects detection of the external anal sphincter: comparison between three-dimensional anal endosonography and endoanal magnetic resonance imaging. Dis Colon Rectum 49:20–27

    Article  PubMed  Google Scholar 

  16. Wisser J, Schār G, Kurmanavicius J, Huch R, Huch A (1999) Use of 3D ultrasound as a new approach to assess obstetrical trauma to the pelvic floor. Ultraschall Med 20:15–18

    Article  PubMed  CAS  Google Scholar 

  17. Hunerbein M, Below C, Schlag PM (1996) Three-dimensional endorectal ultrasonography for staging of obstructing rectal cancer. Dis Colon Rectum 39:636–642

    Article  PubMed  CAS  Google Scholar 

  18. Hunerbein M, Schlag PM (1997) Three-dimensional endosonography for staging of rectal cancer. Ann Surg 225:432–438

    Article  PubMed  CAS  Google Scholar 

  19. Ivanov KD, Diavoc CD (1997) Three-dimensional endoluminal ultrasound: new staging technique in patients with rectal cancer. Dis Colon Rectum 40:47–50

    Article  PubMed  CAS  Google Scholar 

  20. Hunerbein M, Pegios W, Rau B, Vogl TJ, Felix R, Schlag PM (2000) Prospective comparison of endorectal ultrasound, three-dimensional endorectal ultrasound, and endorectal MRI in the preoperative evaluation of rectal tumors. Preliminary results. Surg Endosc 14:1005–1009

    Article  PubMed  CAS  Google Scholar 

  21. Kim JC, Cho YK, Kim SY, Park SK, Lee MG (2002) Comparative study of three-dimensional and conventional endorectal ultrasonography used in rectal cancer staging. Surg Endosc 16:1280–1285

    Article  PubMed  CAS  Google Scholar 

  22. Giovannini M, Bories E, Pesenti C, Moutardier V, Lelong B, Delpéro JR (2006) Three-dimensional endorectal ultrasound using a new freehand software program: results in 35 patients with rectal cancer. Endoscopy 38:339–343

    Article  PubMed  CAS  Google Scholar 

  23. Kim JC, Kim HC, Yu CS, Han KR, Kim JR, Lee KH, Jang SJ, Lee SS, Ha HK (2006) Efficacy of 3-dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging. Am J Surg 192:89–97

    Article  PubMed  Google Scholar 

  24. Hunerbein M, Dohmoto M, Haensch W, Schlag PM (1996) Evaluation and biopsy of recurrent rectal cancer using three-dimensional endosonography. Dis Colon Rectum 39:1373–1378

    Article  PubMed  CAS  Google Scholar 

  25. Christensen AF, Nielsen MB, Svendsen LB, Engelholm SA (2006) Three-dimensional anal endosonography may improve detection of recurrent anal cancer. Dis Colon Rectum 49:1527–1532

    Article  PubMed  Google Scholar 

  26. Löhnert M, Doniec JM, Kovács G, Schröder J, Dohrmann P (1998) New method of radiotherapy for anal cancer with three-dimensional tumor reconstruction based on endoanal ultrasound and ultrasound-guided afterloading therapy. Dis Colon Rectum 41:169–176

    Article  PubMed  Google Scholar 

  27. Giordano P, Grondona P, Hetzer H, Scott M, Williams NS, Lunniss PJ (2004) Three-dimensional endoanal ultrasonography is better than conventional anal endosonography in the assessment of fistula in ano. Dis Colon Rectum 47:607–608

    Google Scholar 

  28. Buchanan GN, Bartram CI, Williams AB, Halligan S, Cohen CR (2005) Value of hydrogen peroxide enhancement of three-dimensional endoanal ultrasound in fistula in ano. Dis Colon Rectum 48:141–147

    Article  PubMed  Google Scholar 

  29. Ratto C, Grillo E, Parello A, Costamagna G, Doglietto GB (2005) Endoanal ultrasound-guided surgery for anal fistula. Endoscopy 37:722–728

    Article  PubMed  CAS  Google Scholar 

  30. West RL, Dwarkasing S, Felt-Bersma RJ, Schouten WR, Hop WC, Hussain SM, Kuipers EJ (2004) Hydrogen peroxide-enhanced three-dimensional endoanal ultrasonography and endoanal magnetic resonance imaging in evaluating perianal fistulas: agreement and patient preference. Eur J Gastroenterol Hepatol 16:1319–1324

    Article  PubMed  Google Scholar 

  31. West RL, Zimmerman DD, Dwarkasing S, Hussain SM, Hop WC, Schouten WR, Kuipers EJ, Felt-Bersma RJ (2003) Prospective comparison of hydrogen peroxide–enhanced three-dimensional endoanal ultrasonography and endoanal magnetic resonance imaging of perianal fistulas. Dis Colon Rectum 46:1407–1415

    Article  PubMed  CAS  Google Scholar 

  32. Halligan S, Bartram CI (1998) MR imaging of fistula in ano: are endoanal coils the gold standard? AJR Am J Roentgenol 171:407–412

    PubMed  CAS  Google Scholar 

  33. West RL, van der Woude CJ, Hansen BE, Felt-Bersma RJ, van Tilburg AJ, Drapers JA, Kuipers EJ (2004) Clinical and endosonographic effect of ciprofloxacin on the treatment of perianal fistulae in Crohn’s disease with infliximab: a double-blind placebo-controlled study. Aliment Pharmacol Ther 20:1329–1336

    Article  PubMed  CAS  Google Scholar 

  34. Rose SC, Kinney TB, Roberts AC, Valji K, Sanfeliz GR, Miller FJ, Pretorius DH, Nelson TR (2005) Endocavitary three-dimensional ultrasonographic assistance for transvaginal or transrectal drainage of pelvic fluid collections. J Vasc Interv Radiol 16:1333–1340

    PubMed  Google Scholar 

  35. West RL, Felt-Bersma RJ, Hansen BE, Schouten WR, Kuipers EJ (2005) Volume measurements of the anal sphincter complex in healthy controls and fecal-incontinent patients with a three-dimensional reconstruction of endoanal ultrasonography images. Dis Colon Rectum 48:540–548

    Article  PubMed  Google Scholar 

  36. Stuhldreier G, Kirschner HJ, Astfalk W, Schweizer P, Huppert PE, Grunert T (1997) Three-dimensional endosonography of the pelvic floor: an additional diagnostic tool in surgery for continence problems in children. Eur J Pediatr Surg 7:97–102

    Article  PubMed  CAS  Google Scholar 

  37. Regadas FS, Murad-Regadas SM, Wexner SD, Rodrigues LV, Souza MH, Silva FR, Lima DM, Regadas Filho FS (2007) Anorectal three-dimensional endosonography and anal manometry in assessing anterior rectocele in women: a new pathogenesis concept and the basic surgical principle. Colorectal Dis 9:80–85

    Article  PubMed  CAS  Google Scholar 

  38. Murad-Regadas SM, Regadas FS, Rodrigues LV, Souza MH, Lima DM, Silva FR, Filho FS (2007) A novel procedure to assess anismus using three-dimensional dynamic anal ultrasonography. Colorectal Dis 9:159–165

    Article  PubMed  CAS  Google Scholar 

  39. Gualdi GF, Casciani E, Guadalaxara A, d’Orta C, Polettini E, Pappalardo G (2000) Local staging of rectal cancer with transrectal ultrasound and endorectal magnetic resonance imaging: comparison with histologic findings. Dis Colon Rectum 43:338–345

    Article  PubMed  CAS  Google Scholar 

  40. Maldjian C, Smith R, Kilger A, Schnall M, Ginsberg G, Kochman M (2000) Endorectal surface coil MR imaging as a staging technique for rectal carcinoma: a comparison study to rectal endosonography. Abdom Imaging 25:75–80

    Article  PubMed  CAS  Google Scholar 

  41. Kim NK, Kim MJ, Yun SH, Sohn SK, Min JS (1999) Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer. Dis Colon Rectum 42:770–775

    Article  PubMed  CAS  Google Scholar 

  42. Zagoria RJ, Schlarb CA, Ott DJ, Bechtold RI, Wolfman NT, Scharling ES, Chen MY, Loggie BW (1997) Assessment of rectal tumor infiltration utilizing endorectal MR imaging and comparison with endoscopic rectal sonography. J Surg Oncol 64:312–317

    Article  PubMed  CAS  Google Scholar 

  43. Tatli S, Mortele KJ, Breen EL, Bleday R, Silverman SG (2006) Local staging of rectal cancer using combined pelvic phased-array and endorectal coil MRI. J Magn Reson Imaging 23:534–540

    Article  PubMed  Google Scholar 

  44. Akin O, Nessar G, Agildere AM, Aydog G (2004) Preoperative local staging of rectal cancer with endorectal MR imaging: comparison with histopathologic findings. Clin Imaging 28:432–438

    Article  PubMed  Google Scholar 

  45. Matsuoka H, Nakamura A, Masaki T, Sugiyama M, Takahara T, Hachiya J, Atomi Y (2003) Comparison between endorectal coil and pelvic phased-array coil magnetic resonance imaging in patients with anorectal tumor. Am J Surg 185:328–332

    Article  PubMed  Google Scholar 

  46. Indinnimeo M, Grasso RF, Cicchini C, Pavone P, Stazi A, Catalano C, Scipioni A, Fanelli F (1996) Endorectal magnetic resonance imaging in the preoperative staging of rectal tumors. Int Surg 81:419–422

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pasquale Giordano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gravante, G., Giordano, P. The role of three-dimensional endoluminal ultrasound imaging in the evaluation of anorectal diseases: a review. Surg Endosc 22, 1570–1578 (2008). https://doi.org/10.1007/s00464-008-9865-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-008-9865-4

Keywords

Navigation