Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Endosonography”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2000

Diagnosis of anal sphincter tears by postpartum endosonography to predict fecal incontinence.

OBJECTIVE: To determine whether anal endosonography immediately after vaginal delivery can predict subsequent fecal incontinence. METHODS: We studied nulliparas who delivered vaginally and had no anal sphincter tears (third- or fourth-degree perineal tears) diagnosed clinically by endosonography before any suture of the perineum. The sonographer was unaware of delivery details and the obstetrician and the women were not informed of endosonography results. Therefore, the suture of the perineum and the outcomes were not influenced by sonographer's diagnoses. Three months after delivery, we assessed fecal incontinence by self-administered questionnaires. RESULTS: Clinically undetected tears of the anal sphincter were diagnosed by anal endosonography in 42 of 150 women (28%). The external anal sphincter alone was involved in 30 women (20%), the internal anal sphincter alone in two (1.3%), and both in ten (7%). The postal questionnaire was returned by 144 women. Incontinence was reported by 22 (15%, 95% confidence interval [CI] 10%, 22%), consisting mainly of incontinence to flatus only (16 of 22, 73%, 95% CI 50%, 89%). Clinically undetected anal sphincter tears diagnosed by endosonography were associated with incontinence 3 months after delivery (odds ratio [OR] 8.8; 95% CI 2.9, 26.5). The sensitivity of anal endosonography was 68% (95% CI 49%, 88%) and the positive predictive value 37% (95% CI 22%, 51%). CONCLUSION: Anal endosonography immediately after vaginal delivery allows diagnosis of clinically undetected anal sphincter tears that might be associated with subsequent fecal incontinence.

Adult↗
PubMed1993

Influence of tumor stenosis on the accuracy of endosonography in preoperative T staging of esophageal cancer.

The T stage is an important criterion for determining prognosis in esophageal carcinoma. Endosonography, although established as a highly accurate method in preoperative determination of the T stage, may be less reliable in non-traversable tumor stenoses. In a comparative prospective study, 41 patients with carcinoma of the esophagus were investigated to determine the role of tumor stenosis on the accuracy of endosonography in preoperative T staging. The results were correlated with the histology of the resected specimen. The overall accuracy in T staging with endosonography was 76%, compared with 49% in computed tomography. T staging results of endosonography were good in easily and non-traversable stenoses (92%, 87% respectively), but lower accuracy was obtained in stenoses which could be traversed only with difficulty (46%). Computed tomography was inferior to endosonography in all three groups of patients. The high accuracy of endosonography in non-traversable stenoses might be due to the fact that all tumors were in an advanced stage (T3 or T4). When passage of the echoendoscope proves difficult, the low focal distance between the ultrasonic transducer and tumor may hamper clear visualisation of the wall layers and tumor penetration depth. These limitations of endosonography should stimulate further efforts in improving ultrasonic resolution in these cases.

Adenocarcinoma↗
PubMedDate not supplied

Staging of rectal cancer: a prospective study of digital examination and endosonography before and after preoperative radiotherapy.

Between January 1988 and January 1992, 34 patients with rectal cancer were evaluated both by clinical examination and endosonography before and after pre-operative radiotherapy. Two criteria were correlated with histologic findings: confinement to the rectal wall or spread beyond, the presence of mesorectal lymph node involvement. The 32 patients who underwent endosonography before radiotherapy were staged as: uT2: 4, uT3: 26, uT4: 2 cases. Fifteen days after irradiation, endosonography showed tumour regression in all cases; uT stage was different in 15 patients, uN stage in 4 cases. Comparison of the pre-operative local invasion beyond the rectal wall with postoperative histopathy revealed a correlation with: digital examination after radiotherapy in 20 of the 31 patients with palpable tumours; endosonography before irradiation in 18 of the 32 staged tumours; endosonography after irradiation in 25 of the 32 staged tumours. The presence of mesorectal lymph node involvement determined by histologic examination was correlated with the results of endosonography after radiotherapy for 22 of the 32 staged tumours. Endosonography provides a good assessment of the tumour stage before irradiation. Since radiotherapy alters endosonographic staging of rectal cancer, this staging should be included in survival studies.

Adenocarcinoma↗
PubMed1998

[Hydrosonography as an alternative or supplement to endosonography in stomach carcinoma].

Transabdominal ultrasound in the hydrotechnique (hydrosonography) was compared with endosonography for the locoregional staging of gastric cancer. For this purpose 52 consecutive patients were examined by endosonography (7.5 and 12 MHz) and hydrosonography (3.75 MHz). Forty-nine of the 52 tumors could be examined by endosonography and 41 by hydrosonography. The T-staging accuracy rate of endosonography was 74% and 46% for hydrosonography. Carcinoma of the cardia are often classified as uT3 and hT3 preoperatively and pT2 postoperatively due to infiltration of the subserosal fat. The N-staging accuracy rate of endosonography was 86% and 61% for hydrosonography. Based on these results, transabdominal ultrasound in the hydrotechnique (hydrosonography) cannot replace endosonography in gastric cancer staging. However, when performed in conjunction with conventional ultrasound, hydrosonography provides useful information about the local tumor stage, especially in cases of advanced and stenotic tumors.

Adult↗
PubMed2000

Prospective assessment of accuracy of endoanal MR imaging and endosonography in patients with fecal incontinence.

OBJECTIVE: Endoanal MR imaging was prospectively compared with anal endosonography to determine any superiority in the characterization of sphincter morphology in fecal incontinence. SUBJECTS AND METHODS: Fifty-two consecutive patients with fecal incontinence were examined with anal endosonography and endoanal MR imaging after a detailed bowel history, clinical examination, and complete anorectal physiologic testing. External and internal anal sphincter integrity was noted on both endosonograms and MR images by two radiologists in consensus, who read individual scans in a random order to avoid recall bias. Imaging findings were subsequently compared, and arbitration of any disagreement between endosonography and MR imaging was made in consensus by a surgeon and a gastroenterologist who also had access to the patient's history, clinical examination, and anorectal physiologic testing results. RESULTS: Complete agreement was found between anal endosonographic and MR imaging interpretations in 32 patients (62%): 10 with combined external and internal sphincter injuries, two with isolated internal sphincter injury, and 20 with intact sphincters. Of 20 patients in whom results of the scans were disparate, incorrect interpretation was found on endosonography in six patients, on MR imaging in 15. Overall, one error relating to the internal sphincter was made on endosonography versus 12 on MR imaging (p = 0.002), and five errors relating to the external sphincter were made on endosonography versus six on MR imaging (p = 1.0). CONCLUSION: This study suggests that endoanal sonography and endoanal MR imaging are equivalent in diagnosing external anal sphincter injury, but MR imaging is inferior in diagnosing internal anal sphincter injury.

Adolescent↗
PubMed1994

Vaginal endosonography. New approach to image the undisturbed anal sphincter.

PURPOSE: Although anal endosonography provides clear images of anal sphincters, the probe in the anal canal may distort epithelial structures and sphincter muscles may be compressed, producing inaccurate muscle thickness measurements. The aim of this study is to describe a new approach using vaginal endosonography to image the anal canal undistorted. METHODS: Twenty females (10 healthy volunteers and 10 with fecal incontinence) had both anal and vaginal endosonography performed. RESULTS: The undisturbed anorectum, submucosa, anal cushions, and anal sphincter muscles were clearly visualized by vaginal endosonography, and anatomy was described. Although anal and vaginal endosonographic measurements of internal sphincter muscle thickness correlated (r = 0.83; P = 0.01), anal endosonography consistently underestimated the thickness (2.3 +/- 0.5 vs. 3.2 +/- 1.2 mm; mean +/- standard deviation). Anterior internal and external anal sphincter defects were identified accurately with both techniques. CONCLUSIONS: Vaginal endosonography is a new technique that enables accurate imaging of anal sphincters and epithelial structures at rest. In addition to making the diagnosis of anal sphincter defects, it has potential applications in the imaging of anovaginal sepsis and malignancy and possibly in understanding the pathogenesis of anal fissure and hemorrhoids.

Adult↗
PubMed1996

Vaginal endosonography to diagnose enterocoele.

Radiological diagnosis of enterocoele is possible using evacuation proctography, but the standard technique must be modified to reveal the small bowel. Since prolapsed bowel is interposed between the vagina and rectum, diagnosis may be possible using vaginal endosonography. We describe a simple ultrasound technique to diagnose enterocoele, which has been validated by comparison with proctography. 17 women were examined with vaginal endosonography, and a diagnosis of enterocoele made if bowel was visualized in the rectovaginal space when bearing down. The findings were compared with subsequent proctography. In eight cases (47%) bowel prolapsed into the rectogenital space during straining, obscuring the rectum, while this did not occur in the remaining nine subjects (53%). Proctography confirmed an enterocoele in six of the eight cases in whom it had been diagnosed on endosonography, and confirmed the absence of enterocoele in all of the nine cases negative on endosonography. These values gave vaginal endosonography a sensitivity of 100% and specificity of 82%, with a positive predictive value of 75%, and negative predictive value of 100% for a prevalence of abnormality of 0.35. Vaginal endosonography is a quick, easy and convenient alternative to evacuation proctography for the radiological diagnosis of enterocoele.

Adult↗
PubMed1993

[Rectal endosonography for perirectal and non-tumor rectal changes].

The value of rectal endosonography was retrospectively evaluated in 39 patients with various rectal and perirectal diseases. Endosonography proved to be very helpful in demonstrating or excluding abscesses. In patients with aspecific minor inflammatory rectal diseases, endosonography was not very helpful. Endosonography is complementary to other imaging techniques like CT and MRI in establishing perirectal tumors. Endosonography shows the relationship of the rectal wall with an extrarectal tumor and is capable of demonstrating the extent of smaller tumors. It may contribute to the diagnosis of endometriosis in the rectovaginal space. In patients with anal pain endosonography can play an important role in demonstrating or excluding fistulas, abscesses and other diseases.

Abscess↗
PubMed1998

Anal endosonography in patients with anorectal symptoms after haemorrhoidectomy.

BACKGROUND: Anorectal symptoms after haemorrhoidectomy are common and treatment is often empirical. Because of this, an audit was carried out of the value of anal endosonography in patients with anorectal symptoms after haemorrhoidectomy. METHODS: Between May 1993 and February 1997, 16 patients (ten men and six women of median age 56 (range 35-77) years) were investigated by anal endosonography for anorectal symptoms after haemorrhoidectomy which involved anorectal incontinence (n = 10), anal pain (n = 4) and obstructive defaecation (n = 2). The findings were compared with those in a matched group of asymptomatic patients after haemorroidectomy. RESULTS: Anal endosonography demonstrated an abnormality in 12 symptomatic patients. Of the ten patients with anorectal incontinence, endosonography showed an internal anal sphincter defect (n = 5), a combined sphincter defect (n = 2) and an isolated external anal sphincter defect (n = 1). Normal appearances were seen in all asymptomatic patients. The endosonographic abnormalities of the four patients with anal pain included internal anal sphincter defect (n = 1), extrinsic mass (n = 1), and intersphincteric abscess (n = 1). One of the two patients with obstructive defaecation had an isolated external anal sphincter defect on endosonography. CONCLUSION: These results show a high yield of endosonographic abnormalities in patients who experience symptoms after haemorrhoidectomy. In particular, occult sphincter injury as a cause of incontinence in these patients can frequently be demonstrated.

Adult↗
PubMed1996

[Endosonography of the pharynx].

BACKGROUND: Endosonography is a diagnostic tool for the examination of tumors of the oral cavity. The pharynx is usually not assessable for conventional endosonography due to problems with the placement of the probe in deeper areas of the pharynx. PATIENTS: A fingertop ultrasonography probe was combined with a stick allowing the user to locate the probe in deeper areas of the pharynx. The stick had two flexible joints and a device for attaching the probe in the front. We evaluated 48 patients with tumors of the posterior wall of the pharynx (n = 6), lateral wall of the pharynx (n = 7), tonsil (n = 17), sinus piriformis (n = 13), and nasopharynx (n = 5) during preoperative tumor endoscopy under general anesthesia. Thirty-two patients suspected of having a tonsillar abscess were examined under local anesthesia. RESULTS: The evaluation of the tumor dissemination and the determination of the relationship between the tumor and the internal carotid artery was excellent for tumors of the posterior and lateral wall of the pharynx. The investigation of tumors of the sinus piriformis and the nasopharynx was difficult and tumor growth could not be determined normally with endosonography. In four cases, retropharyngeal lymph nodes could be detected. The sensitivity for the diagnosis of tonsillar abscesses was 84%. CONCLUSION: Endosonography of the deeper areas of the pharynx seems to be a useful instrument for investigating growth of tumors at the lateral and posterior wall of the pharynx. Endosonographic results might be helpful for deciding between endoscopic and external approaches. Endosonography is not sufficiently sensitive for diagnosing tonsillar abscesses, but might be helpful in clinically difficult cases.

Abscess↗
PubMed2003

Endosonography in the evaluation of anal function after primary repair of a third-degree obstetric tear.

BACKGROUND: Disruption of the anal sphincter occurs in 0.6%-6% of women during delivery and almost half have persistent defecatory symptoms despite primary repair. Our aim was to prospectively analyse anal endosonography and rectoanal manometry after primary repair of a third-degree obstetric tear in order to compare the findings with the clinical outcome. METHODS: Twenty-one women aged 27-41 (mean 31.5 years) who had undergone primary suture of a third-degree disruption of the anal sphincter were interviewed on their pelvic floor function and explored by manometry and endosonography 4 months after delivery. RESULTS: Twelve women had anal incontinence. External sphincter defect was identified on endosonography in 22% continent and in 91% incontinent women (P < 0.01). The presence of an external sphincter defect was associated with anal incontinence in 91.7%. Surgical repair was identified on endosonography in 88% continent women and in 25% incontinent women (P < 0.03). The combination of a visible surgical repair and absence of defect was highly associated with normal continence (91.7%). Squeezing pressures were higher in continent women (87 +/- 23 cm H2O) than in incontinent women (48 +/- 36 cm H2O; P = 0.04), but no anal pressure threshold could achieve better results than endosonography in predicting the clinical outcome. CONCLUSION: After primary repair of a third-degree obstetric tear, endosonographic pattern of the anal sphincter correlates with the continence status.

Adult↗
PubMed1991

Preoperative detection of intrathoracic tumor spread of esophageal cancer: endosonography versus computed tomography.

The results of endosonography and computed tomography, using an optimized CT technique, have been compared in the preoperative detection of intrathoracic tumor spread of esophageal cancer. In 22/40 patients with esophageal tumors complete passage of the ultrasonic endoscope was possible. Endosonography was superior to CT in the assessment of early stage of esophageal tumor (T1-2). Out of 9 tumors confined to the esophageal wall, 8 were classified correctly by endosonography and only 5 by computed tomography. The results in advanced T3 and T4 tumors (13 patients) were comparable following endosonography and computed tomography. Endosonography is an important means of selecting patients with early-stage cancers in whom a curative resection is still a possibility.

Carcinoma↗
PubMed1992

Anal endosonography: relationship with anal manometry and neurophysiologic tests.

Thirty-seven patients were referred for evaluation of anal function; their clinical diagnoses were traumatic fecal incontinence (13), idiopathic (pudendal neuropathy) fecal incontinence (7), fecal soiling (9), and other (8). In all patients, anal endosonography (sphincter defects and internal sphincter thickness [IST]) and anal manometry (maximal basal pressure [MBP] and maximal squeeze pressure [MSP]) were performed. In 18 patients, neurophysiologic tests (EMG-maximal contraction pattern [MCP], single-fiber EMG [fiber density; FD], and pudendal nerve terminal motor latency [PNTML]) were also performed. Endosonography demonstrated in seven patients both an internal and external sphincter defect (Group 1), in seven patients an internal sphincter defect and in one patient an external sphincter defect (Group 2), and in 22 patients no sphincter defect (Group 3). There was a significant difference among these three groups for MBP and MCP, the lowest being in Group 1. Between the patients with traumatic fecal incontinence and idiopathic fecal incontinence, no differences in IST, MBP, MSP, MCP, FD, and PNTML were found. In two patients with a suspected obstetric trauma, there was an unexpected additional severe pudendal neuropathy. In one patient with a suspected obstetric trauma, no damage of the anal sphincters could be demonstrated. In one patient with suspected idiopathic fecal incontinence, there was an additional, unsuspected defect of the internal sphincter. There was concordance between endosonography and EMG in the mapping of the external sphincter. Clinical diagnoses can be misleading in differentiating between traumatic and idiopathic fecal incontinence; anal endosonography provides unsuspected and additional information about the sphincters; PNTML can reveal unsuspected neuropathy in traumatic fecal incontinence. Therefore, the combination of endosonography and PNTML is promising in selecting patients for surgery.

Adolescent↗
PubMedDate not supplied

Endosonography in the evaluation of patients with Barrett's esophagus and high-grade dysplasia.

Endosonography, which provides high-resolution images of the esophageal wall, could potentially detect carcinoma not visible endoscopically in patients with Barrett's esophagus and high-grade dysplasia. We studied the ability of endosonography to detect early esophageal carcinoma in 9 patients with Barrett's esophagus and high-grade dysplasia who were candidates for esophagectomy. Pre-operative endoscopy and biopsy revealed high-grade dysplasia without evidence of carcinoma in all patients. Pre-operative endosonographic evaluations were compared to the pathologic diagnoses of resected specimens. Post-operatively, 3 of the 9 patients were found to have intra-mucosal carcinoma. Endosonography identified a tumor in only 1 of these 3 patients and over-staged it as invasive carcinoma (T2, N1). In 2 of the 6 patients without intra-mucosal carcinoma, endosonography predicted invasive carcinoma (T2, N0). Endoscopy revealed mucosal nodularity in each of the 3 over-staged patients. We conclude that recommendation of the routine use of endosonography to determine the need for surgery in patients with Barrett's esophagus and high-grade dysplasia would be premature, because the current generation of echo-endoscopes does not reliably differentiate between benign and malignant wall thickening.

Adenocarcinoma↗
PubMed1991

Evaluation of endosonography in sclerotherapy of esophageal varices.

During intravariceal sclerotherapy of esophageal varices with polidocanol in 32 patients with portal hypertension due to liver cirrhosis of various etiologies, endosonographic assessment of both esophageal and gastric intramural vessels was carried out in order to evaluate the usefulness of endosonography in the follow-up of the variceal status. In all cases endosonography demonstrated esophageal and gastric varices; in contrast, only five cases of gastric varices could be demonstrated by endoscopy. Furthermore, different stages of variceal obliteration following sclerotherapy could be demonstrated by means of endosonography, and it was possible to identify incomplete obliteration in about one-third of the patients in whom inadequate sclerotherapy was suspected endoscopically. In addition, the status of gastric varices during sclerotherapy was demonstrated by means of endosonography. Only in cases of adequate sclerotherapy of esophageal varices, as assessed by both endoscopic and endosonographic criteria, were gastric varices plugged. On the basis of these findings endosonography would appear to be a useful technique for the diagnosis and follow-up of esophageal and gastric varices during intravariceal sclerotherapy.

Esophageal and Gastric Varices↗
PubMed1991

Biologic aggressiveness of palpable and nonpalpable prostate cancer: assessment with endosonography.

The biologic aggressiveness of palpable versus nonpalpable prostate cancer was evaluated in 666 patients studied with endosonography over a 24-month period. Biologic aggressiveness was defined by a combined histologic and grade-stage category score. In 314 patients suspected of having prostate cancer 328 biopsies were performed. Carcinoma was detected in 99 patients, by means of both palpation and endosonography (n = 80), endosonography alone (n = 9), and palpation alone (n = 8); two cancers were not detected with either palpation or endosonography. All patients with normal results of digital examination had a combined grade-stage category score lower than 9. Fifty-five of 69 patients (80%) with abnormal results of digital examination and available histologic data had a histologic score of 6 or higher; 38 of these patients (69%) had a combined grade-stage category score of 9 or higher. Although the number of patients is small, these data suggest that nonpalpable cancers are biologically less aggressive than palpable ones and that the advantage of endosonography over palpation in detection of clinically significant cancers is limited.

Adenocarcinoma↗
PubMed1997

Transvaginal versus anal endosonography for detecting damage to the anal sphincter.

OBJECTIVE: We undertook this study to establish the accuracy of transvaginal endosonography for detecting damage to the anal sphincter. SUBJECTS AND METHODS: Anal endosonography was performed in 47 parous patients and one nulliparous patient using a sonographic scanner, an 1850 endoprobe, and a 10-MHz transducer protected by a water-filled hard plastic cone. This procedure was followed by transvaginal sonography using the same system but with a water-filled balloon in 43 and a dedicated vaginal probe Type 8551 of 10-MHz frequency in five. Axial images were obtained as low in the perineum as possible. The transvaginal images were reviewed with the observer unaware of the findings from anal endosonography and were then compared with the anal endosonograms. RESULTS: The transvaginal images were inadequate for review in three patients. In the remaining 45 patients, anal endosonography showed internal sphincter defects in 18 and external sphincter tears in 21. Transvaginal endosonography showed eight internal and 10 external sphincter defects only, giving a sensitivity of 44% and a specificity of 96% for the detection of internal sphincter defects and a sensitivity of 48% and a specificity of 88% for external sphincter tears. CONCLUSION: Transvaginal examination is not accurate for assessing the anal sphincter because of the anatomic limitations this approach imposes on axial imaging of the anal canal.

Adult↗
PubMed1993

Anorectal endosonography in benign anorectal disorders.

Anal endosonography is an excellent method of visualising the anal sphincters and the pelvic floor. In particular, defects in the internal and external anal sphincters can be demonstrated. Thickness of the sphincters can also be measured. Fistulas and abscesses can be visualised. The clinical indications for performing anal endosonography are: (i) Faecal incontinence and soiling, to detect a possible sphincter defect. In combination with anorectal function tests (like anal manometry, rectal compliance, EMG and pudendal nerve latency measurements), the cause of faecal incontinence or soiling can be determined. (ii) Fistulae and abscesses, to detect the extension of the lesion in relation to the anal sphincters and deeper structures. (iii) Constipation, to exclude a hypertrophic sphincter. (iv) Pre- and postoperative in ileo-rectal and ileo-anal anastomosis, to demonstrate or exclude anal sphincter defects. (v) Pre- and postoperatively in all patients who undergo anorectal surgery to be informed about possible anal sphincter abnormalities. Anorectal function tests should also be performed when anal endosonography is done in evaluating possible faecal incontinence. For scientific interest all anorectal disorders like haemorrhoids, fissures and inflammatory bowel disease offer challenges to anal endosonography. In conclusion, anal endosonography is an easy to perform test of great importance in patients with anorectal pathology, especially in patients with faecal incontinence or soiling and patients who need anorectal surgery to be informed about possible sphincter defects.

Anus Diseases↗