Double-Contrast Barium Enema and Computerised Tomography in the Pre-Operative Evaluation of Rectal Carcinoma: Are they Still Useful Diagnostic Procedures?
| Autor: | Gianfrancesco Gallino, Guido Cozzi, Roberto Gallo, Filiberto Belli, Giuliano Bonfanti, Salvatore Andreola, Lucio Bertario, Elia Biganzoli, Ermanno Leo, Monica Salvetti, Luigi Mariani, Enrico Civelli |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Cancer Research
medicine.medical_specialty medicine.medical_treatment Contrast Media Rectum Enema Adenocarcinoma Sensitivity and Specificity 030218 nuclear medicine & medical imaging Diagnosis Differential 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Inferior mesenteric lymph nodes Rectal ampulla Preoperative Care medicine Humans Neoplasm Staging Barium enema Rectal Neoplasms business.industry Reproducibility of Results General Medicine Anal canal Double-contrast barium enema Barium sulfate medicine.anatomical_structure Oncology chemistry 030220 oncology & carcinogenesis Radiology Barium Sulfate Tomography X-Ray Computed business |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 2038-2529 0300-8916 |
| DOI: | 10.1177/030089160008600504 |
| Popis: | Purpose In modern management of rectal carcinoma, the preoperative evaluation of disease parameters is important for selection of therapeutic options. Such parameters are currently defined through endorectal ultrasonography or endoscopic ultrasonography. A retrospective analysis of the parameters obtained with double-contrast barium enema (DCBE) and endorectal balloon computed tomography (CT) was conducted to verify the diagnostic reliability of the radiological techniques and to establish whether there is still an indication for their use. Methods 53 consecutive patients with adenocarcinoma of the distal half of the rectal ampulla underwent double contrast barium enema examination and CT of the pelvis with endorectal balloon. On the basis of the DCBE and CT assessment we evaluated: 1) the distance between the cranial extremity of the anal canal and the distal margin of the neoplasm; 2) the radial diffusion of the tumor; 3) the metastatic involvement of the perirectal and inferior mesenteric lymph nodes. Results 1) CT and DBCE measurements of the distal margin tended to coincide, but both tended to overestimate the measurement when compared to the pathologic examination; 2) in the identification of neoplastic infiltration of perirectal fat (T3) CT had 100% sensitivity, 78.7% specificity and 86.8% accuracy; 3) the CT sensitivity for detecting lymph node metastasis was 52.6%, specificity 85.3% and accuracy 73.6%. Conclusions The diagnostic information provided by the radiological examinations is comparable to that of clinical and instrumental methods currently employed for staging of rectal carcinoma, although the latter are preferred because they are more readily accessible and less costly. DCBE and CT can therefore be usefully employed for staging of cancer of the rectum in those cases in which there are limitations of the current standard methods. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|