Ultrasonographic criteria for the prevalence of tumor of the colon process
Science Articles / / August 12, 2017
In the last decade, colorectal cancer has attracted particular attention.According to various authors of the tumor lesion localization takes approximately 10 to 12% (Trapeznikov NN, Aksel EM, 1997).Over the last 5 years is not marked significant changes in the structure and in absolute terms, the incidence of colon cancer.A high percentage of mortality - up to 50% (GI Vorobiev, Odaryuk TS, Shelygin Yu, 1998) primarily related to poor diagnosis.
One of the main tasks in the preoperative stage is to determine the degree of invasion of the intestinal wall and thus the spread of the tumor to the surrounding organs, which allows to properly assess the therapeutic tactics and volume of surgical intervention.Of particular interest in the diagnosis of this disease is ultrasonography, which is highly informative and non-invasive technique in determining the localization of any tumors.
The study included a survey of 68 patients.Among them, 38 men and 30 women.Diagnostic studies were carried out
When transabdominal examination of the correct location of the tumor is defined in 90.3% of cases.The main localization was observed in the projection of a straight line (up 34.2%) and sigmoid colon (23%) the most frequent primary tumor of colon adenocarcinoma - usually located in the left parts of the colon (up 67.7%) and limited to a relatively short segment (on average to 5.7 cm).Failures in identifying tumors of the colon transabdominal access m mainly depended either by poor preparation, pronounced subcutaneous fat, or because of the small size of the tumor (usually less than 2 cm).
When bowel tumors, especially ultrasound picture hung there on the tumor growth direction (endo - or exophytic), its structure, the degree of involvement in the pathological process of adjacent organs and a number of other reasons.For symptom PPO bowel tumors according to our data, characterized by: irregular shape, the lack of symmetry of the image, the wall thickness is usually more than 1 cm, the absence of peristalsis in the affected area, narrowing of the intestinal lumen.
Normally during transabdominal ultrasound bowel wall has a three-layer structure.When tumors differentiation of these layers is disturbed respectively surround stages of the process.Stage T1 during transabdominal our study was not found.The majority of patients identified stage TK and T4 (totaled 85.3%).Stage 12 was detected in 14.7% of patients.
should be noted that if a significant amount of the tumor (more than 10-15 cm) it is difficult to determine the length and find out where it occurs.Particular attention is paid to the presence of distortion, discontinuity, fuzzy outer contour of the lesion ulcer;displace the spine at the last breath and palpation for screen control;violation of borders neighboring organs, ie,ultrasonic signs pointing to an extension to the serous membrane and then outside the intestine.
Patients with bowel obstruction, tumor obstruction to the development of marked increase in the diameter of the bowel above the tumor.
Of particular interest is the investigation of tumor blood vessels, as the nature of the vascularization of tumors provides a measure of growth and invasiveness (Tuhbatullin MG, Akhmetzyanov F.Sh., Savelyev NA, 2002).In assessing the nature of the vascularization it was found that for tumors of the colon in our studies prevailed mosaic (887%) the type of blood.
In cases when tumors showed signs of infection at the DRC visualized vessels beyond the tumor and invade surrounding tissues and organs.
found a significant decrease in V max When quantify blood flow in tumors of the colon (27,6 ± 3,2; at a rate of 47.6 ± 4, 5) and RI (0,4 ± 0,08 at a rate of 0.72 ±0.04) and increased V min (17,2 ± 2,3, at a rate of 13,0 ± 1,2).
Thus, ultrasonography is a highly informative method to identify and evaluate the spread of tumor of the colon.Nevertheless, ultrasound should be considered only in conjunction with other diagnostic procedures (endoscopic and radiological).