By Giulio Aniello Santoro M.D., Ph.D., Giuseppe Di Falco M.D. (auth.)
Read or Download Atlas of Endoanal and Endorectal Ultrasonography: Staging and Treatment Options for Anorectal Cancer PDF
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Additional resources for Atlas of Endoanal and Endorectal Ultrasonography: Staging and Treatment Options for Anorectal Cancer
Five and possibly six hypo echoic and hyperechoic layers can be seen (Fig. I1L6) . From inner to outer, these are: 1) HYPERECHOIC: interface with the plas- tic cone 2) HYPOECHOIC: mucosa 3) HYPERECHOIC: subepithelial tissues 4) HYPOECHOIC: internal anal sphincter 5) HYPERECHOIC: longitudinal muscle 6) MIXED ECHOGENICITY: external anal sphincter Fig. 2. The voluntary and involuntary muscle of the anal canal (cadaveric specimen) Section 11/- Basic anatomy 29 Puborectalis -lilococcygeus muscles Puborectalis muscle a muscle L-______________________________________________ ~ b c Anococcygeal ~ ________________________________________________________ ~ Fig.
EAUS has been criticized because believed highly operator dependent and for its limited field of view and contrast resolution, which would make it less useful for pelvic floor muscle imaging; so, MR has been suggested as a better diagnostic procedure. However, differences in definition of anal canal anatomy have been described in relation to the technique used. The endoanal coil has been used for a long time [5,15,21,221, but recently it has been believed to distort the anatomy and a phased-array technique has been preferred [231.
The sagittal projection suggests that the lateral margin of the tumor is confined to the muscolaris propria Fig. 27. The scan image in multi-view with 6 types of cube image presentation Section /I. Endoanal and endorectal ultrasonographic techniques 21 3600 rotating head, the proximal-distal actuation mechanism and the electronic mover are fully enclos~d within the housing of the slim probe (Fig. 28). Both 3D data set acquisition and high precision positioning of the scan head over a longitudinal distance of 60 mm are accomplished at the touch of a button, allowing getting the information without having to move the probe's position.