Hépato-Gastro & Oncologie Digestive


Value of the three-dimensional anal endosonography in proctological practice Volume 16, issue 6, novembre-décembre 2009


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Proctologie médico-interventionnelle, centre hospitalier Diaconesses-Croix-Saint-Simon, site Reuilly, 18, rue du Sergent-Bauchat, 75012 Paris, France

Three-dimensional endoanal ultrasonography (3D EAUS) provides unequalled quality in terms of the anatomical image of the anal canal and sphincter apparatus. In less than one minute, it produces a three-dimensional “cube” that can be manipulated in all spatial dimensions, then archived. In just a few years, it has thus become the additional proctology reference exploration, all the more so as it has other advantages since it is easily and rapidly performed, is well tolerated and moderate in cost. In anal incontinence, 3D EAUS helps reveal sphincter lesions. The anatomy of the sphincters can be evaluated spatially, with calculation, by a simple method that can be used in routine practice and is based on correct reproducibility scores, of the “damaged sphincter volume”. In the management of anoperineal suppurations, 3D EAUS provides information on the fistula path or paths and on possible collections. These data are vital as the choice of treatment and its efficacy depend on accurate topographic assessment of the suppuration and the state of the sphincter apparatus.