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Transrectal Sonography of Anal Sphincter Infiltration in Lower Rectal Carcinoma

¹ Department of Radiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
² Department of Surgery, University of Vienna, A-1090 Vienna, Austria.
³ Department of Clinical Pathology, University of Vienna, A-1090 Vienna, Austria.

OBJECTIVE. The purpose of the study was to assess the accuracy of transrectal sonography in determining invasion by lower rectal cancer into the anal canal.

SUBJECTS AND METHODS. Thirty-eight patients (14 women, 24 men; mean age, 65 years) with lower rectal cancer underwent transrectal sonography before surgery. Both depth of infiltration and tumor invasion into the anal canal were assessed, and results were compared with histopathology of the resected specimens.

RESULTS. Infiltration into the anal canal was found histopathologically in 12 (32%) of 38 patients. Transrectal sonography revealed a true-positive diagnosis in 11 of these 12 patients. A false-positive diagnosis of anal canal infiltration was made in two patients for a sensitivity of 91%, a specificity of 85%, and an accuracy of 92%. In the 11 patients diagnosed correctly on transrectal sonography, the depth of tumor infiltration into the anal canal corresponded with histopathology.

CONCLUSION. This study shows that transrectal sonography is an accurate method for assessment of anal canal infiltration in lower rectal cancer.

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