The Value Of Endorectal Ultrasound In Evaluating The Efficacy Of Neoadjuvant Chemoradiotherapy For Advanced Rectal Cancer

Objective: To explore the application value of endorectal ultrasound(ERUS),contrast-enhanced ultrasound(CEUS)and ultrasonic elastography(UE)in the treatment of neoadjuvant chemoradiotherapy for advanced rectal cancer.Methods: To collect 40 cases of T3 and T4 stage rectal cancer patients admitted to the people’s hospital of xinjiang uygur autonomous region from October 2016 to September 2017.All patients underwent ERUS,contrast-enhanced ultrasound and ultrasonic elastography examination before surgery for neoadjuvant chemoradiotheraphy(N-CRT),and compare with postoperative pathological.(1)Evaluate the consistency of T stage,N stage between endorectal ultrasound and pathological,(2)Evaluate ERUS,contrast-enhanced ultrasound and elastography were used to compare the area after tumor reduction.(3)Evaluate contrast-enhanced ultrasound and intestinal wall and scar tissue parameters.Results: (1)In 40 patients with advanced rectal cancer,post-neoadjuvant chemoradiotheraphy,the total accuracy for uT staging was 60%,over-stage was 22.5% and under rstage was 17.5%.Comparison of ERUS and ERUS combined contrast-enhanced ultrasound was performed by the paired chi-square test,P<0.05,and the positive detection rate of ERUS joint angiography was higher than that of ERUS.,the positive predictive value was 88.88%,and the negative predictive value was 21.05%.Kappa=0.22,it showed that ERUS and ERUS combined contrast-enhanced ultrasound were less consistent in T staging of rectal cancer patients post-neoadjuvant chemoradiotheraphy.(2)In 40 patients with advanced rectal cancer,post-neoadjuvant chemoradiotheraphy,the total accuracy for uN staging was 65.0%,over-stage was 12.5% and under rstage was 22.5%.Comparison of ERUS and ERUS combined contrast-enhanced ultrasound was performed by the paired chi-square test,P<0.05,and the positive detection rate of ERUS joint contrast-enhanced ultrasound was higher than that of ERUS,the positive predictive value was 92.85%,and the negative predictive value was 41.67%,Kappa=0.34,it showed that ERUS and ERUS combined co ntrast-enhanced ultrasound were less consistent in N staging of rectal cancer patients post-neoadjuvant chemoradiotheraphy.(3)Post-neoadjuvant chemoradiotheraphy,ERUS,contrast-enhanced ultrasound and elastography were compared between groups(P<0.05),the difference was statistically significant.(4)Post-neoadjuvant chemoradiotheraphy,ultrasound contrast was performed to test the parameters of the rectal wall and the tumor(P<0.05),and the contrast test between the scar and the tumor was performed(P<0.05),and the difference was statistically significant.Conclusions: ERUS and ERUS combined contrast-enhanced ultrasound and elastography technology for uT stage and uN stage positive detection rate were higher;Contrast-enhanced ultrasound is of high value after neoadjuvant chemoradiotheraphy.