Atlas Of Anal Endosonography

It is now more than 40 years since Drs. Wild and Reid published their first experience with rectal ultrasonography from the Surgery Department at the University of Minnesota. Professor Owen H. Wangen steen, in whose laboratory the studies were carried out, recognized at that time the need for early detection in the treatment of cancer. Technical improvements over the past 20 years have made endoscopy the procedure of choice for examination of the hollow organs of the genital, urinary and gastrointestinal tracts. The simultaneous development of endosonography has had an equally dramatic impact on the practice of medicine and surgery. The technology has been demonstrated to be helpful in both benign and malignant conditions. One of the so-called benign conditions of the anorectum is fistula-in-ano. Fistula surgery has always relied on excellent anatomic delineation of the intramuscular tracts. There is hope that adaptation of ultrasonographic technology will aid in the surgical management of this malady. Clearly, rectal ultrasonography has considerable potential in the management of rectal carcinoma. Accuracy rates in the range of 90% for the depth of neoplastic invasion have been reported. This ability for accurate assessment will undoubtedly lead to a better definition of the population of patients that can be managed by local therapeutic means.

It is now more than 40 years since Drs. Wild and Reid published their first experience with rectal ultrasonography from the Surgery Department at the University of Minnesota. Professor Owen H. Wangen steen, in whose laboratory the studies were carried out, recognized at that time the need for early detection in the treatment of cancer. Technical improvements over the past 20 years have made endoscopy the procedure of choice for examination of the hollow organs of the genital, urinary and gastrointestinal tracts. The simultaneous development of endosonography has had an equally dramatic impact on the practice of medicine and surgery. The technology has been demonstrated to be helpful in both benign and malignant conditions. One of the so-called benign conditions of the anorectum is fistula-in-ano. Fistula surgery has always relied on excellent anatomic delineation of the intramuscular tracts. There is hope that adaptation of ultrasonographic technology will aid in the surgical management of this malady. Clearly, rectal ultrasonography has considerable potential in the management of rectal carcinoma. Accuracy rates in the range of 90% for the depth of neoplastic invasion have been reported. This ability for accurate assessment will undoubtedly lead to a better definition of the population of patients that can be managed by local therapeutic means.

Imaging is now central to the investigation and management of anorectal and pelvic floor disorders. This has been brought about by technical developments in imaging, notably, three-dimensional ultrasound and magnetic resonance imaging (MRI), which allow high anatomical resolution and tissue differentiation to be presented in a most usable fashion. Three-dimensional endosonography in anorectal conditions and MRI in anal fistula are two obvious developments, but there are others, with dynamic st- ies of the pelvic floor using both ultrasound and MRI coming to the fore. This atlas provides an easy way to gain a detailed understanding of imaging in this field. The atlas is divided into four sections covering the basic anatomy, anal/perianal disease, rectal/perirectal disease and functional assessment. One of the difficulties with developing an atlas is to strike the right balance - tween text and images. Too much text and it is not an atlas; too little text and the - ages may not be understood. The editors of this atlas are to be congratulated on achi- ing an appropriate balance. The images are all that one expects from an atlas, and the diagrams are excellent. The commentaries at the end of invited chapters are a valuable addition, placing what are relatively short, focussed chapters into context. They add balance and depth to the work and are well worth reading.

With contributions by numerous experts

The Atlas of Endoscopic Ultrasonography provides readers with a large collection of excellent images obtained from both diagnostic and therapeutic procedures. The Atlas includes a DVD which will be an invaluable addition to the library of trainee and practising gastroenterologists with video clips and searchable database of images. Together the book and DVD offer a first class collection of images to give a highly integrated introduction to endoscopic ultrasonography. The Atlas is an ideal companion to Dr Gress et al’s Endoscopic Ultrasonography, Second Edition.

Imaging is now central to the investigation and management of anorectal and pelvic floor disorders. This has been brought about by technical developments in imaging, notably, three-dimensional ultrasound and magnetic resonance imaging (MRI), which allow high anatomical resolution and tissue differentiation to be presented in a most usable fashion. Three-dimensional endosonography in anorectal conditions and MRI in anal fistula are two obvious developments, but there are others, with dynamic st- ies of the pelvic floor using both ultrasound and MRI coming to the fore. This atlas provides an easy way to gain a detailed understanding of imaging in this field. The atlas is divided into four sections covering the basic anatomy, anal/perianal disease, rectal/perirectal disease and functional assessment. One of the difficulties with developing an atlas is to strike the right balance - tween text and images. Too much text and it is not an atlas; too little text and the - ages may not be understood. The editors of this atlas are to be congratulated on achi- ing an appropriate balance. The images are all that one expects from an atlas, and the diagrams are excellent. The commentaries at the end of invited chapters are a valuable addition, placing what are relatively short, focussed chapters into context. They add balance and depth to the work and are well worth reading.