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术前直肠内超声检查(EUS)判断直肠癌浸润深度的正确率90%,对淋巴结转移确诊率73～86%,较肛门指检可靠。作者采用EUS对17例属T_3、T_4直肠癌患者放疗前后就肿瘤大小,浸润深度和淋巴结累及情况的超声波图像变化作了研究,并比较了手术标本,组织学检查结果。因正常肠壁超声图像上呈现5条声带,3条高回声带,是由声束进出一定厚度的解剖层所致;2条低回声带是直肠粘膜和固有肌层形成,按TNM分期提出超声波肿瘤分期(μTNM),肿瘤位粘膜和粘膜下层为μT_(?),在第1条低回声带内;μT_2肿瘤浸及固有肌层,位第2条低回声带,而且第2条高回声带出现中断;μT_a肿瘤已浸及直肠周围脂肪,直肠壁层次破坏;μT_4肿瘤已浸及周围脏器。完全被肿瘤浸润的淋巴结,图像出现“黑洞”,与肿瘤相
Preoperative rectal ultrasound examination (EUS) judged the accuracy of rectal cancer infiltration depth of 90%, and the diagnosis rate of lymph node metastasis was 73 to 86%, which was more reliable than the anal index. The authors used EUS to study the changes of ultrasound images before and after radiotherapy in 17 cases of T_3 and T_4 patients with rectal cancer, and to compare the surgical specimens and histological examination results. Five vocal cords were present on the ultrasound image of the normal bowel wall, and three high echo bands were caused by sound beams entering and leaving a certain thickness of the anatomical layer; two hypoechoic bands were formed by the rectal mucosa and the muscularis propria, and ultrasound was presented by TNM staging. Tumor stage (μTNM), tumor mucosa and submucosa were μT_(?) in the first hypoechoic zone; μT_2 tumor invasion and muscularis propria, 2nd hypoechoic zone, and 2nd hyperechoic zone Interruption occurred; μT_a tumors had been immersed in the fat around the rectum and the rectal wall was damaged; μT_4 tumors had been immersed in the surrounding organs. Lymph nodes that are completely infiltrated by tumors, the image appears “black hole”, and the tumor