Water Enema Transvaginal Ultrasound for Local Staging of Stenotic Rectal Carcinoma

Background: To increase the value of ultrasound in the staging of stenotic rectal carcinoma. Methods: Water enema transvaginal ultrasound (WE-TVUS) was performed in 21 consecutive female patients with severely stenotic rectal tumor (adenocarcinoma histologically proved) who were selected on the basis of clinical and double-contrast barium enema study. All patients underwent surgery, and histopathologic correlation was possible. Results: Rectal tumors were well demonstrated in all cases, and a good correlation between perirectal neoplastic infiltration, and lymph node involvement at WE-TVUS and histologic data were observed. Compared with histologic results, WE-TVUS correctly staged 19 of 21 tumors (overall accuracy = 90%); one case was understaged (T4 as T3) and one case was overstaged (T3 as T4). In the detection of lymph node involvement, the sensitivity was 50% and specificity was 78%. Conclusion: WE-TVUS is a potentially valuable technique for defining the local extension of severely stenotic rectal tumors in women. Received: 10 December 1997/Accepted: 28 January 1998