METHOD OF MULTI-PARAMETER ENDORECTAL ULTRASONIC EXAMINATION OF RECTAL ADENOMA AND THEIR MALIGNIZATION Russian patent published in 2021 - IPC A61B8/08 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to coloproctology, and can be used for multiparametric endorectal ultrasonic examination of rectal adenoma and maligination. An examination is performed in the patient's elbow-elbow position or lying on the left side using a linear rigid sensor with frequency of 5-10 MHz in real time throughout the tumor using a rigid linear sensor placed in the latex balloon with a close fit to the analyzed rectal region. At the first stage, B-mode ultrasonic examination is performed, then, at the second stage, energy Doppler sonography is performed. At the third stage, in the process of compression ultrasonic elastography, a linear sensor performs a rhythmic alternation of cycles of mechanical compression-expansion action. At the fourth stage, an ultrasonic examination is performed in the position of the patient lying on the left side or in the knee-elbow position using a radial rectal sensor with frequency of 10-16 MHz in real time throughout the tumor. A rectoscope is inserted into the patient's rectum, the tumor is visualized using a magnifying window with an optic-fiber illuminator. After the magnification window is removed, a radial endorectal ultrasonic sensor sealed in the latex balloon is inserted into the rectoscope lumen with a retroscope attachment fixed on its handle. Based on the obtained data, a volumetric tumor image is constructed. When visualizing thickening of the rectal wall by a mucous layer, differentiating the submucosal and muscular layers with unbroken angioarchitectonics and vascularization, mosaic type of color mapping with uniform distribution of color areas, characteristic for soft tissues, and stiffness coefficient less than 5.745 cu is diagnosed with rectal adenoma. When imaging the thickening of the rectal wall by the mucous layer, differentiating the submucosal and muscular layers in determining the long tree-like vascular loci with the amputation pattern of one or more loci, presence of separate interrupted vascular loci or avascular portions of the new growth with energy Doppler sonography, in a mixed type of color mapping with local prevalence of color areas characteristic of hard tissues and stiffness coefficient more than 5.745 cu, non-invasive rectal adenocarcinoma (in situ cancer) is diagnosed. When visualizing intestinal wall thickening by mucous layer and intestinal wall structure disorder with partial differentiation or impossibility to determine submucous and underlying layers, when determining extended vascular tree loci with a pattern of "amputation" of several loci, presence of separate interrupted vascular loci or avascular portions of the new growth with energy Doppler ultrasound and mixed type of color mapping with predominance of 50% and more color areas specific for rigid tissues, and stiffness coefficient more than 5.745 cu, invasive rectal adenocarcinoma is diagnosed.

EFFECT: method provides the diagnosis of rectal adenoma with concealed malignancy by four-step ultrasonic examination.

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