藤井 康友, 畠 二郎, 寺面 和史, 二神 浩司, 小根森 元, 末永 健二

Yasutomo FUJII, Jiro HATA, Kazushi TERAMEN, Koji FUTAGAMI, Gen KONEMORI, Kenji SUENAGA

公立三次中央病院消化器科

Department of Gastroenterology Miyoshi General Hospital

キーワード : Advanced colorectal cancer, Ultrasonographic diagnosis, Transperineal ultrasonography

We studied the diagnostic useful of extracorporeal ultrasonography in advanced colorectal cancer. Sonographic findings were compared with colonoscopic or radiographic findings in 493 patients, 41 of whom had colorectal cancer. Sonographic examination was performed with no prior knowledge of the patient's status. Ultrasonographic diagnosis of colorectal cancer was based on local distribution of abnormal wall thickening, loss of wall stratification, mucosal⁄srosal irregularity, and loss of compressibility. As a result, sonographic screening of advanced colorectal cancer had high sensitivity (85.4%), high specificity (99.3%), and a high rate of detection (85.4%). Misdiagnoses were made by less experienced examiners, regardless of tumor size or other tumor-related factors. Because all of the undetected tumors were at the sigmoid colon and rectum, anatomical factors may have interfered with tumor detection. Transperineal ultrasonography was effective in the detection of rectal cancers, which were not demonstrable by transabdominal ultrasonography. Ultrasonography, which is safe and non-invasive, was thus shown to be a potentially useful modality in the primary diagnosis of advanced colorectal cancer.