CC BY-NC-ND 4.0 · Ultrasound Int Open 2019; 05(01): E34-E51
DOI: 10.1055/a-0825-6708
Review
Eigentümer und Copyright ©Georg Thieme Verlag KG 2019

EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound

Dieter Nuernberg*
1   Medical School Brandenburg Theodor Fontane, Gastroenterology, Neuruppin, Germany
,
Adrian Saftoiu*
2   Research Center in Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Craiova, Romania
,
Ana Paula Barreiros
3   Deutsche Stiftung Organtransplantation, Head of Organisation Center Middle, Frankfurt, Germany
,
Eike Burmester
4   Department of Internal Medicine/Gastroenterology, Sana-Kliniken Lübeck, Lübeck, Germany
,
Elena Tatiana Ivan
2   Research Center in Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Craiova, Romania
,
Dirk-André Clevert
5   Department of Clinical Radiology, Interdisciplinary Ultrasound-Center, University of Munich-Grosshadern Campus, Munich, Germany
,
Christoph F. Dietrich
6   Caritas-Krankenhaus, Medizinische Klinik 2, Bad Mergentheim, Germany
,
Odd Helge Gilja
7   National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway
,
Torben Lorentzen
8   Ultrasound Section, Division of Surgery, Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
,
Giovanni Maconi
9   Gastroenterology Unit, Department of Biomedical and Clinical Sciences, “L.Sacco” University Hospital, Milan, Italy
,
Ismail Mihmanli
10   Istanbul University – Cerrahpasa, Cerrahpasa Medical Faculty, Department of Radiology and ALKA Radyoloji Tani Merkezi, Istanbul, Turkey
,
Christian Pallson Nolsoe
11   Ultrasound Section, Division of Surgery, Department of Gastroenterology, Herlev Hospital and Copenhagen Academy for Medical Education and Simulation (CAMES), University of Copenhagen, Denmark
,
Frank Pfeffer
12   Department of Surgery, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway
,
Søren Rafael Rafaelsen
13   Colorectal Centre of Excellence, Clinical Cancer Centre, University Hospital of Southern Denmark, Vejle, Denmark
,
Zeno Sparchez
14   3rd Medical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
,
Peter Vilmann
15   Endoscopy Department, Copenhagen University Hospital Herlev, Herlev, Denmark
,
Jo Erling Riise Waage
12   Department of Surgery, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway
› Author Affiliations
Further Information

Publication History

received 07 April 2018
revised 23 November 2018

accepted 01 December 2018

Publication Date:
05 February 2019 (online)

Abstract

This article represents part 3 of the EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound (GIUS). It provides an overview of the examination techniques recommended by experts in the field of endorectal/endoanal ultrasound (ERUS/EAUS), as well as perineal ultrasound (PNUS). The most important indications are rectal tumors and inflammatory diseases like fistula and abscesses in patients with or without inflammatory bowel disease (IBD). PNUS sometimes is more flexible and convenient compared to ERUS. However, the technique of ERUS is quite well established, especially for the staging of rectal cancer. EAUS also gained ground in the evaluation of perianal diseases like fistulas, abscesses and incontinence. For the staging of perirectal tumors, the use of PNUS in addition to conventional ERUS could be recommended. For the staging of anal carcinomas, PNUS can be a good option because of the higher resolution. Both ERUS and PNUS are considered excellent guidance methods for invasive interventions, such as the drainage of fluids or targeted biopsy of tissue lesions. For abscess detection and evaluation, contrast-enhanced ultrasound (CEUS) also helps in therapy planning.

* First 2 authors contributed equally to the manuscript.


 
  • References

  • 1 Kim MJ. Transrectal ultrasonography of anorectal diseases: Advantages and disadvantages. Version 2. Ultrasonography 2015; 34: 19-31
  • 2 Cârţână ET, Pârvu D, Săftoiu A. Endoscopic ultrasound: Current role and future perspectives in managing rectal cancer patients. J Gastrointestin Liver Dis 2011; 20: 407-413
  • 3 Kav T, Bayraktar Y. How useful is rectal endosonography in the staging of rectal cancer?. World J Gastroenterol 2010; 16: 691-697
  • 4 Steele SR, Martin MJ, Place RJ. Flexible endorectal ultrasound for predicting pathologic stage of rectal cancers. Am J Surg 2002; 184: 126-130
  • 5 Colaiácovo R, Assef MS, Ganc RL. et al. Rectal cancer staging: Correlation between the evaluation with radial echoendoscope and rigid linear probe. Endosc Ultrasound 2014; 3: 161-166
  • 6 Fábián A, Bor R, Farkas K, Bálint A. et al. Rectal tumor staging with endorectal ultrasound: Is there any difference between western and eastern european countries?. Gastroenterol Res Pract 2016; 2016: 8631381
  • 7 Ustundag Y, Fusaroli P. Are rigid probes sufficient to provide reliable data for rectal cancer staging?. Endosc Ultrasound 2015; 4: 270
  • 8 Cârţână ET, Gheonea DI, Săftoiu A. Advances in endoscopic ultrasound imaging of colorectal diseases. World J Gastroenterol 2016; 22: 1756-1766
  • 9 Giovannini M, Ardizzone S. Anorectal ultrasound for neoplastic and inflammatory lesions. Best Pract Res Clin Gastroenterol 2006; 20: 113-135
  • 10 Dietrich CF, Averkiou MA, Correas JM. et al. An EFSUMB introduction into dynamic contrast-enhanced ultrasound (DCE-US) for quantification of tumor perfusion. Ultraschall Med 2012; 14: 344-351
  • 11 Piscaglia F, Nolsøe C, Dietrich CF. et al. The EFSUMB guidelines and recommendations on the clinical practice of contrast Enhanced Ultrasound (CEUS): Update 2011 on non-hepatic applications. Ultraschall Med 2012; 33: 33-59
  • 12 Lu M, Yan B, Song J. et al. Double-contrast-enhanced sonography for diagnosis of rectal lesions with pathologic correlation. J Ultrasound Med 2014; 33: 575-583
  • 13 Wang Y, Li L, Wang YX, Cui NY, Zou SM, Zhou CW. et al. Time-intensity curve parameters in rectal cancer measured using endorectal ultrasonography with sterile coupling gels filling the rectum: Correlations with tumor angiogenesis and clinicopathological features. Biomed Res Int 2014; 2014: 587806
  • 14 Cartana ET, Gheonea DI, Cherciu IF et al. Assessing tumor angiogenesis in colorectal cancer by quantitative contrast-enhanced endoscopic ultrasound and molecular and immunohistochemical analysis. Endosc Ultrasound 2017 [Epub ahead of print]
  • 15 Bamber J, Cosgrove D, Dietrich CF. et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall in Med 2013; 34: 169-184
  • 16 Cosgrove D, Piscaglia F, Bamber J. et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications. Ultraschall in Med 2013; 34: 238-253
  • 17 Rafaelsen SR, Vagn-Hansen C, Sørensen T. et al. Ultrasound elastography in patients with rectal cancer treated with chemoradiation. Eur J Radiol 2013; 82: 913-917
  • 18 Rafaelsen SR, Vagn-Hansen C, Sørensen T. et al. Elastography and diffusion-weighted MRI in patients with rectal cancer. Br J Radiol 2015; 88: 20150294
  • 19 Waage JER, Havre RF, Leh S. et al. Endorectal elastography in the evaluation of rectal tumors. Colorectal Dis 2011; 13: 1130-1137
  • 20 Waage JER, Rafaelsen SR, Borley NR. et al. Strain Elastography Evaluation of Rectal Tumors: Inter- and Intraobserver Reproducibility. Ultraschall Med 2015; 36: 611-617
  • 21 Waage JER, Leh S, Røsler C. et al. Endorectal ulstrasonography, strain elastography and MRI differentiation of rectal adenomas and adenocarcinomas. Colorectal Dis 2015; 17: 124-131
  • 22 Waage JER, Bach SP, Pfeffer F. et al. Combined endorectal ultrasonography and strain elastography for the staging of early rectal cancer. Colorectal Dis 2015; 17: 50-56
  • 23 Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK. et al. AJCC Cancer Staging Manual. 8th Edition Springer International Publishing; 2017
  • 24 Beets-Tan RGH, Lambregts DMJ, Maas M. et al. Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol 2018; 28: 1465-1475
  • 25 Puli SR, Bechtold ML, Reddy JB, Choudhary A, Antillon MR, Brugge WR. How good is endoscopic ultrasound in differentiating various T stages of rectal cancer? Meta-analysis and systematic review. Ann Surg Oncol 2009; 16: 254-265
  • 26 Zhou Y, Shao W, Lu W. Diagnostic value of endorectal ultrasonography for rectal carcinoma: A meta-analysis. J Can Res Ther 2014; 10: 319-322
  • 27 Fernandez-Esparrach G, Ayuso-Colella JR, Sendino O. et al. EUS and magnetic resonance imaging in the staging of rectal cancer: A prospective and comparative study. Gastrointest Endosc 2011; 74: 347-354
  • 28 Puli SR, Bechtold ML, Reddy JB. et al. Can endoscopic ultrasound predict early rectal cancers that can be resected endoscopically? A meta-analysis and systematic review. Dig Dis Sci 2010; 55: 1221-1229
  • 29 Zorcolo L, Fantola G, Cabras F. et al. Preoperative staging of patients with rectal tumors suitable for transanal endoscopic microsurgery (TEM): Comparison of endorectal ultrasound and histopathologic findings. Surg Endosc 2009; 23: 1384-1389
  • 30 Glancy DG, Pullyblank AM, Thomas MG. The role of colonoscopic endoanal ultrasound scanning (EUS) in selecting patients suitable for resection by transanal endoscopic microsurgery (TEM). Colorectal Dis 2005; 7: 148-150
  • 31 Carmody BJ, Otchy DP. Learning curve of transrectal ultrasound. Dis Colon Rectum 2000; 43: 193-197
  • 32 Rafaelsen SR, Sorensen T, Jakobsen A. et al. Transrectal ultrasonography and magnetic resonance imaging in the staging of rectal cancer. Effect of experience. Scand J Gastroenterol 2008; 43: 440-446
  • 33 Morris OJ, Draganic B, Smith S. Does a learning curve exist in endorectal two-dimensional ultrasound accuracy?. Tech Coloproctol 2011; 15: 301-311
  • 34 Marusch F, Ptok H, Sahm M. et al. Endorectal ultrasound in rectal carcinoma – do the literature results really correspond to the realities of routine clinical care?. Endoscopy 2011; 43: 425-431
  • 35 Rafaelsen SR, Kronborg O, Fenger C. Echo pattern of lymph nodes in colorectal cancer: An in vitro study. Br J Radiol 1992; 65: 218-220
  • 36 Puli SR, Reddy JB, Bechtold ML. et al. Accuracy of endoscopic ultrasound to diagnose nodal invasion by rectal cancers: A meta-analysis and systematic review. Ann Surg Oncol 2009; 16: 1255-1265
  • 37 Li L, Chen S, Wang K. et al. Diagnostic value of endorectal ultrasound in preoperative assessment of lymph node involvement in colorectal cancer: A meta-analysis. Asian Pac J Cancer Prev 2015; 16: 3485-3491
  • 38 Li XT, Sun YS, Tang L. et al. Evaluating local lymph node metastasis with magnetic resonance imaging, endoluminal ultrasound and computed tomography in rectal cancer: A meta-analysis. Colorectal Dis 2015; 17: O129-O135
  • 39 Fernández-Esparrach G, Alberghina N, Subtil JC. et al. Endoscopic ultrasound-guided fine needle aspiration is highly accurate for the diagnosis of perirectal recurrence of colorectal cancer. Dis Colon Rectum 2015; 58: 469-473
  • 40 Dumonceau JM, Polkowski M, Larghi A. et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2011; 43: 897-912
  • 41 Marone P, de Bellis M, Avallone A. et al. Accuracy of endoscopic ultrasound in staging and restaging patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiation. Clin Res Hepatol Gastroenterol 2011; 35: 666-670
  • 42 Memon S, Lynch AC, Bressel M. et al. Systematic review and meta-analysis of the accuracy of MRI and endorectal ultrasound in the restaging and response assessment of rectal cancer following neoadjuvant therapy. Colorectal Dis 2015; 17: 748-761
  • 43 Mihmanli I, Kantarci F, Dogra VS. Endoanorectal Ultrasonography. Ultrasound Quarterly 2011; 27: 87-104
  • 44 Lorentzen T, Nolsoe C, Skjoldbye B. Ultrasound-guided drainage of deep pelvic abscesses: Experience with 33 cases. Ultrasound in medicine & biology 2011; 37: 723-728
  • 45 Christensen AF, Nielsen MB, Engelholm SA, Roed H, Svendsen LB, Christensen H. Three-dimensional anal endosonography may improve staging of anal cancer compared with two-dimensional endosonography. Dis Colon Rectum 2004; 47: 341-345
  • 46 Christensen AF, Nyhuus B, Nielsen MB. Interobserver and intraobserver variation of two-dimensional and three-dimensional anal endosonography in the evaluation of recurrent anal cancer. Dis Colon Rectum 2009; 52: 484-488
  • 47 Pezim ME, Spencer RJ, Stanhope CR. et al. Sphincter repair for fecal incontinence after obstetrical or iatrogenic injury. Dis Colon Rectum 1987; 30: 521-525
  • 48 Glynne-Jones R, Nilsson PJ, Aschele C. et al. Anal cancer: ESMO-ESSO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. European journal of surgical oncology: The journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 2014; 40: 1165-1176
  • 49 Jacopo M. EAUS for anal cancer staging. International Journal of Colorectal Disease 2011; 26: 385-386
  • 50 Martellucci J, Naldini G, Colosimo C. et al. Accuracy of EAUS in the follow-up assessment for squamous cell carcinoma of the anal canal treated with radiochemotherapy. Surgical Endoscopy 2009; 23: 1054-1057
  • 51 Otto SD, Lee L, Buhr HJ. et al. Staging anal cancer: Prospective comparison of transanal endoscopic ultrasound and magnetic resonance imaging. Journal of gastrointestinal surgery: Official Journal of the Society for Surgery of the Alimentary Tract 2009; 13: 1292-1298
  • 52 Parikh J, Shaw A, Grant LA. et al. Anal carcinomas: The role of EAUS and magnetic resonance imaging in staging, response evaluation and follow-up. European Radiology 2011; 21: 776-785
  • 53 Tarantino D, Bernstein MA. EAUS in the staging and management of squamous-cell carcinoma of the anal canal: Potential implications of a new ultrasound staging system. Diseases of the Colon and Rectum 2002; 45: 16-22
  • 54 Drudi FM, Raffetto N, De Rubeis M. et al. ERUS staging and follow-up in patients with anal canal cancer. La Radiologia Medica 2003; 106: 329-337
  • 55 Giovannini M, Bardou VJ, Barclay R. et al. Anal carcinoma: Prognostic value of endorectal ultrasound (ERUS). Results of a prospective multicenter study. Endoscopy 2001; 33: 231-236
  • 56 Sirikurnpiboon S, Phadhana-anake O, Awapittaya B. Comparison of Endoanal Ultrasound with Clinical Diagnosis in Anal Fistula Assessment. J Med Assoc Thai 2016; 99 (Suppl. 02) S69-S74
  • 57 Toyonaga T, Tanaka Y, Song JF, Katori R. et al. Comparison of accuracy of physical examination and endoanal ultrasonography for preoperative assessment in patients with acute and chronic anal fistula. Tech Coloproctol 2008; 12: 217-223
  • 58 Wiese DM, Beaulieu D, Slaughter JC. et al. Use of endoscopic ultrasound to guide adalimumab treatment in perianal crohn’s disease results in faster fistula healing. Inflamm Bowel Dis 2015; 21: 1594-1599
  • 59 Spradlin NM, Wise PE, Herline AJ. et al. A randomized prospective trial of endoscopic ultrasound to guide combination medical and surgical treatment for Crohnʼs perianal fistulas. Am J Gastroenterol 2008; 103: 2527-2535
  • 60 Schwartz DA, White CM, Wise PE, Herline AJ. Use of endoscopic ultrasound to guide combination medical and surgical therapy for patients with Crohnʼs perianal fistulas. Inflamm Bowel Dis 2005; 11: 727-732
  • 61 Ardizzone S, Maconi G, Colombo E. et al. Perianal fistulae following infliximab treatment: Clinical and endosonographic outcome. Inflamm Bowel Dis 2004; 10: 91-96
  • 62 Lahat A, Assulin Y, Beer-Gabel M. et al. Endoscopic ultrasound for perianal Crohnʼs disease: Disease and fistula characteristics, and impact on therapy. J Crohns Colitis 2012; 6: 311-316
  • 63 Parks AG, Gordon PH, Hardcastle JD. A classification of fistula-in-ano. Br J Surg 1976; 63: 1-12
  • 64 Alabiso ME, Iasiello F, Pellino G. et al. 3D-EAUS and MRI in the Activity of Anal Fistulas in Crohnʼs Disease. Gastroenterol Res Pract 2016; 2016: 1895694
  • 65 Siddiqui MR, Ashrafian H, Tozer P. et al. A diagnostic accuracy meta-analysis of endoanal ultrasound and MRI for perianal fistula assessment. Dis Colon Rectum 2012; 55: 576-585
  • 66 Gustafsson UM, Kahvecioglu B, Aström G. et al. Endoanal ultrasound or magnetic resonance imaging for preoperative assessment of anal fistula: A comparative study. Colorectal Dis 2001; 3: 189-197
  • 67 Tepes B, Cerni I. The use of different diagnostic modalities in diagnosing fistula-in-ano. Hepatogastroenterology 2008; 55: 912-915
  • 68 Tsankov T, Tankova L, Deredjan H. et al. Contrast-enhanced endoanal and transperineal sonography in perianal fistulas. Hepatogastroenterology 2008; 55: 13-16
  • 69 Panes J, Bouhnik Y, Reinisch W. et al. Imaging techniques for assessment of inflammatory bowel disease: Joint ECCO and ESGAR evidence-based consensus guidelines. J Crohns Colitis 2013; 7: 556-585
  • 70 Murad-Regadas SM, Regadas FS, Rodrigues LV. et al. The role of 3-dimensional anorectal ultrasonography in the assessment of anterior trans-sphincteric fistula. Dis Colon Rectum 2010; 53: 1035-1040
  • 71 Garcés-Albir M, García-Botello SA, Esclapez-Valero P. et al. Quantifying the extent of fistulotomy. How much sphincter can we safely divide? A three-dimensional endosonographic study. Int J Colorectal Dis 2012; 27: 1109-1116
  • 72 Ding JH, Bi LX, Zhao K. et al. Impact of three-dimensional endoanal ultrasound on the outcome of anal fistula surgery: A prospective cohort study. Colorectal Dis 2015; 17: 1104-1112
  • 73 Viganò C, Losco A, Caprioli F. et al. Incidence and clinical outcomes of intersphincteric abscesses diagnosed by anal ultrasonography in patients with Crohn's disease. Inflamm Bowel Dis 2011; 17: 2102-2108
  • 74 Brillantino A, Iacobellis F, Di Sarno G. et al. Role of tridimensional endoanal ultrasound (3D-EAUS) in the preoperative assessment of perianal sepsis. Int J Colorectal Dis 2015; 30: 535-542
  • 75 Khati NJ, Sondel Lewis N, Frazier AA. et al. CT of acute perianal abscesses and infected fistulae: A pictorial essay. Emerg Radiol 2015; 22: 329-335
  • 76 Albuquerque A. Endoanal ultrasonography in fecal incontinence: Current and future perspectives. World J Gastrointest Endosc 2015; 7: 575-581
  • 77 Sultan AH, Kamm MA, Talbot IC. et al. Anal endosonography for identifying external sphincter defects confirmed histologically. Br J Surg 1994; 81: 463-465
  • 78 Jeppson PC, Paraiso MF, Jelovsek JE. et al. Accuracy of the digital anal examination in women with fecal incontinence. Int Urogynecol J 2012; 23: 765-768
  • 79 Malouf AJ, Williams AB, Halligan S. et al. Prospective assessment of accuracy of endoanal MR imaging and endosonography in patients with fecal incontinence. AJR Am J Roentgenol 2000; 175: 741-745
  • 80 Dobben AC, Terra MP, Slors JF. et al. External anal sphincter defects in patients with fecal incontinence: Comparison of endoanal MR imaging and endoanal US. Radiology 2007; 242: 463-471
  • 81 West RL, Dwarkasing S, Briel JW. et al. Can three-dimensional endoanal ultrasonography detect external anal sphincter atrophy? A comparison with endoanal magnetic resonance imaging. Int J Colorectal Dis 2005; 20: 328-333
  • 82 Cazemier M, Terra MP, Stoker J. et al. Atrophy and defects detection of the external anal sphincter: Comparison between three-dimensional anal endosonography and endoanal magnetic resonance imaging. Dis Colon Rectum 2006; 49: 20-27
  • 83 Dietz HP. Pelvic floor ultrasound: A review. Am J Obstet and Gynecol 2010; 202: 321-334
  • 84 Nuernberg D. Perineale Sonographie. In Kursbuch. (Hrsg.) Dietrich CF. Dt. Ärzteverlag; 2019. in press
  • 85 Simanowski JH. Perineal ultrasonography of anal and low rectal illnesses - meaningful instrument in the clinical everyday life. Ultraschall Med 2004; 25: 108-110
  • 86 Rubens DJ, Strang JG, Bogineni-Misra S. et al. Transperineal sonography of the rectum: Anatomy and pathology revealed by sonography compared with CT and MR imaging. AJR Am J Roentgenol 1998; 170: 637-642
  • 87 Dietrich CF, Allgayer H, Müller G, Paolucci V. Anorektale (ARUS) und endorektale (ERUS) Endosonographie. In: Dietrich CF. (editor.) Endoskopischer Ultraschall – Eine Einführung. Konstanz: Schnetztor Verlag; 2005: 294-315
  • 88 Dietrich CF. Endoscopic ultrasound. An introduction. Thieme Verlag; 2006
  • 89 Sailer M, Allgayer H, Dietrich CF. Endoanale und endorektale Sonographie. In: Dietrich CF. (editor). Endosonographie. Stuttgart: Thieme Verlag; 2008: 390-413
  • 90 Dietrich CF, Barreiros AP, Nuernberg D. et al. Perianal ultrasound. Z Gastroenterol 2008; 46: 625-630
  • 91 Han TI, Kim IO, Kim WS. et al. ultrasound identification of the anal sphincter complex and levator ani muscle in neonates: Infracoccygeal approach. Radiology 2000; 217: 392-394
  • 92 Merz E. Transducer hygiene – an underrated topic?. Ultraschall Med 2005; 26: 7-8
  • 93 Albuquerque A, Pereira E. Current applications of transperineal ultrasound in gastroenterology. World J Radiol 2016; 8: 370-377
  • 94 Mallouhi A, Bonatti H, Peer S. et al. Detection and characterization of perianal inflammatory disease: Accuracy of transperineal combined gray scale and color Doppler sonography. J Ultrasound Med 2004; 23: 19-27
  • 95 Pistor G. Sonographic visualization of the axial level of the anal sphincters. Preliminary results in children. Ultraschall Med 2003; 24: 250-254
  • 96 Jurgens J. Perineal sonography: Using time modulated 2D-ultrasound in a freehand 3D technique. Ultraschall Med 2004; 25: 54-57
  • 97 García Mejido JA, Suárez Serrano CM, Fernández Palacín A. et al. Evaluation of levator ani muscle throughout the different stages of labor by transperineal 3D ultrasound. Neurourol Urodyn 2017; 36: 1776-1781
  • 98 Raimondo D, Youssef A, Mabrouk M. et al. Pelvic floor muscle dysfunction at 3D/4D transperinal ultrasound in patients with deep infiltrating endometriosis: A pilot study. Ultrasound Obstet Gynecol 2017; 50: 527-532
  • 99 Dietz HP, Steensma AB. Posterior compartment prolapse on two-dimensional and three-dimensional pelvic floor ultrasound: The distinction between true rectocele, perineal hypermobility and enterocele. Ultrasound Obstet Gynecol 2005; 26: 73-77
  • 100 Kołodziejczak M, Santoro GA, Słapa RZ. et al. Usefulness of 3D transperineal ultrasound in severe stenosis of the anal canal: Preliminary experience in four cases. Tech Coloproctol 2014; 18: 495-501
  • 101 Oom DM, West RL, Schouten WR. et al. Detection of anal sphincter defects in female patients with fecal incontinence: A comparison of 3-dimensional transperineal ultrasound and 2-dimensional endoanal ultrasound. Dis Colon Rectum 2012; 55: 646-652
  • 102 Onik G, Barzell W. Transperineal 3D mapping biopsy of the prostate: An essential tool in selecting patients for focal prostate cancer therapy. Urol Oncol 2008; 26: 506-510
  • 103 Huang WC, Yang SH, Yang JM. Three-dimensional transperineal sonographic characteristics of the anal sphincter complex in nulliparous women. Ultrasound Obstet Gynecol 2007; 30: 210-220
  • 104 Dietrich CF. Anorectal endosonography. Elastography Medix 2008; Supplement 54-57
  • 105 Allgayer H, Ignee A, Dietrich CF. Endosonographic elastography of the anal sphincter in patients with fecal incontinence. Scand J Gastroenterol 2010; 45: 30-38
  • 106 Woźniak MM, Pawelec A, Wieczorek AP. et al. 2D/3D/4D contrast-enhanced voiding urosonography in the diagnosis and monitoring of treatment of vesicoureteral reflux in children - can it replace voiding cystourethrography?. J Ultrason 2013; 13: 394-407
  • 107 Bonatti H, Lugger P, Hechenleitner P. et al. Transperineal sonography in anorectal disorders. Ultraschall Med 2004; 25: 111-115
  • 108 Stewart LK, McGee J, Wilson SR. Transperineal and transvaginal sonography of perianal inflammatory disease. AJR Am J Roentgenol 2001; 177: 627-632
  • 109 Barreiros AP, Hirche TO, Ignee A. et al. Indications and limitations of perineal ultrasound examination. Scand J Gastroenterol 2010; 45: 764-765
  • 110 Magdeburg B, Fried M, Meyenberger C. Endoscopic ultrasonography in the diagnosis, staging, and follow-up of anal carcinomas. Endoscopy 1999; 31: 359-364
  • 111 Morris J, Spencer JA, Ambrose NS. MR imaging classification of perianal fistulas and its implications for patient management. Radiographics 2000; 20: 623-635
  • 112 Sainio P. Fistula-in-ano in a defined population. Incidence and epidemiological aspects. Ann Chir Gynaecol 1984; 73: 219-224
  • 113 Wedemeyer J, Kirchhoff T, Manns MP, Gebel MJ, Bleck JS. Transcutaneous perianal ultrasound (PAUS) for the imaging of fistulas and abscesses in Crohnʼs disease. Z Gastroenterol 2004; 42: 1315-1320
  • 114 Caprioli F, Losco A, Vigano C, Conte D, Biondetti P, Forzenigo LV. et al. Computer-assisted evaluation of perianal fistula activity by means of anal ultrasound in patients with Crohn's disease. Am J Gastroenterol 2006; 101: 1551-1558
  • 115 American Gastroenterological Association Clinical Practice Committee . American Gastroenterological Association medical position statement: Perianal Crohn’s disease. Gastroenterology 2003; 125: 1503-1507
  • 116 Maconi G, Ardizzone S, Greco S. et al. Transperineal ultrasound in the detection of perianal and rectovaginal fistulae in Crohn’s disease. Am J Gastroenterol 2007; 102: 2214-2219
  • 117 Maconi G, Tonolini M, Monteleone M. et al. Transperineal perineal ultrasound versus magnetic resonance imaging in the assessment of perianal Crohnʼs disease. Inflamm Bowel Dis 2013; 19: 2737-2743
  • 118 Hwang JY, Yoon HK, Kim WK. et al. Transperineal ultrasonography for evaluation of the perianal fistula and abscess in pediatric Crohn disease: Preliminary study. Ultrasonography 2014; 33: 184-190
  • 119 Maconi G, Greco MT, Asthana AK. Transperineal Ultrasound for Perianal Fistulas and Abscesses – A Systematic Review and Meta-Analysis. Ultraschall Med 2017; 38: 265-272
  • 120 Terracciano F, Scalisi G, Bossa F. et al. Transperineal ultrasonography: First level exam in IBD patients with perianal disease. Dig Liver Dis 2016; 48: 874-879
  • 121 Bor R, Farkas K, Bálint A, Szűcs M, Ábrahám S, Milassin Á. et al. Prospective comparison of magnetic resonance imaging, transrectal and transperineal sonography, and surgical findings in complicated perianal crohn disease. J Ultrasound Med 2016; 35: 2367-2372
  • 122 Wright EK, Novak KL, Lu C, Panaccione R, Ghosh S, Wilson SR. Transperineal ultrasonography in perianal Crohn disease: A valuable imaging modality. Can J Gastroenterol Hepatol 2015; 29: 445-447
  • 123 Bezzio C, Bryant RV, Manes G. et al. New horizons in the imaging of perianal Crohnʼs disease: Transperineal ultrasonography. Expert Rev Gastroenterol Hepatol 2017; 28: 1-8
  • 124 Rasul I, Wlson SR, MacRae H. et al. Clinical and radiological response after Infliximab treatment for perianal fistulizing Crohn’s disease. Am J Gastroenterol 2003; 99: 82-88
  • 125 Bartram CI, Sultan AH. Anal endosonography in faecal incontinence. Gut 1995; 37: 4-6
  • 126 Bordeianou L, Lee KY, Rockwood T. et al. Anal resting pressures at manometry correlate with the Fecal Incontinence Severity Index and with presence of sphincter defects on ultrasound. Dis Colon Rectum 2008; 51: 1010-1014
  • 127 Andrews V, Sultan AH, Thakar R. et al. Occult anal sphincter injuries – myth or reality?. BJOG 2006; 113: 195-200
  • 128 Wheeler TL, Richter HE. Delivery method, anal sphincter tears and fecal incontinence: New information on a persistent problem. Curr Opin Obstet Gynecol 2007; 19: 474-479
  • 129 Saranovic D, Krivokapic Z, Masulovic D. et al. Endoanal ultrasonography in establishing the diagnosis of fecal incontinence. Acta Chir Iugosl 2007; 54: 159-162
  • 130 Beer-Gabel M, Assoulin Y, Amitai M. et al. A comparison of dynamic transperineal ultrasound (DTP-US) with dynamic evacuation proctography (DEP) in the diagnosis of cul de sac hernia (enterocele) in patients with evacuatory dysfunction. Int J Colorectal Dis 2008; 23: 513-519
  • 131 Cornelia L, Stephan B, Michel B, Antoine W, Felix K. Trans-perineal versus endo-anal ultrasound in the detection of anal sphincter tears. Eur J Obstet Gynecol Reprod Biol 2002; 103: 79-82
  • 132 Martellucci J, Naldini G. Clinical relevance of transperineal ultrasound compared with evacuation proctography for the evaluation of patients with obstructed defaecation. Colorectal Dis 2011; 13: 1167-1172
  • 133 Roos AM, Abdool Z, Sultan AH, Thakar R. The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: The PREDICT study. Clin Radiol 2011; 66: 597-604
  • 134 Son JK, Taylor GA. Transperineal ultrasonography. Pediatr Radiol 2014; 44: 193-201
  • 135 Shek KL, Guzman-Rojas R, Dietz HP. Residual defects of the external anal sphincter following primary repair: An observational study using transperineal ultrasound. Ultrasound Obstet Gynecol 2014; 44: 704-709
  • 136 Valsky DV, Cohen SM, Lipschuetz M. et al. Three-dimensional transperineal ultrasound findings associated with anal incontinence after intrapartum sphincter tears in primiparous women. Ultrasound Obstet Gynecol 2012; 39: 83-90
  • 137 Weemhoff M, Kluivers KB, Govaert B. et al. Transperineal ultrasound compared to evacuation proctography for diagnosing enteroceles and intussusceptions. Int J Colorectal Dis 2013; 28: 359-363
  • 138 Roche B, Deleaval J, Fransioli A. et al. Comparison of transanal and external perineal ultrasonography. Eur Radiol 2001; 11: 1165-1170
  • 139 Bader W, Tunn R, Viereck V. et al. Introital and perineal sonography in diagnosing stress urinary incontinence - possible clinical applications. Ultraschall Med 2004; 25: 181-190
  • 140 Han TI, Kim IO, Kim WS. Imperforate anus: Ultrasound determination of the type with infracoccygeal approach. Radiology 2003; 228: 226-229
  • 141 Kim IO, Han TI, Kim WS. et al. Transperineal ultrasonography in imperforate anus: Identification of the internal fistula. J Ultrasound Med 2000; 19: 211-216
  • 142 Zbar AP, Murison R. Transperineal ultrasound in the assessment of haemorrhoids and haemorrhoidectomy: A pilot study. Tech Coloproctol 2010; 14: 175-179
  • 143 Sperling DC, Needleman L, Eschelman DJ. et al. Deep pelvic abscesses: Transperineal US-guided drainage. Radiology 1998; 208: 111-115