New equipment for transrectal ultrasonomography has been developed. Wth this equipment an excellent cross-section picture of various intrapelvic organs is easily obtained. Diagnostic application of the technique is particularly significant for abnormalities of the prostate because the shape of the prostate cannot be revealed by x-ray. Diagnostic criteria for prostatic disease are described, with the demonstration of typical cases. In a test by well trained physicians the diagnostic accuracy of the new technique was more than 80 per cent. Ultrasonotomography provided for precise measurement of prostatic size. Transrectal ultrasonotomography is a promising new diagnostic technique that yeilds abundant information not available with former methods of examination. The procedure is likely to become one of th most important diagnostic tools in the field of urology.

No abstract

We have successfully developed a new type of equipment for transrectal ultrasonography. The equipment consists of three parts: a transducer assembly, a radial scanner, and a chair. The specially designed transrectal transducer assembly consists of a double tube system; a concave oscillating disc is attached to the rotative inner tube. The t o p of the transducer tube is covered with a water-filled rubber balloon which is kept in contact with the rectal wall. The chair has a hole over which the anus is positioned and the tube with the radial scanner is introduced into the rectum from below. The angle of the. projecting transducer tube can be shifted freely with a lever. The depth of insertion of the transducer is controlled by the scanner handle. This "sitting posture" procedure has several advantages over the lithotomy position. The diagnostic application of this method is described for examination of different intrapelvic organs such as the prostate, the urinary bladder and the uterus.

Gray scale transrectal ultrasongraphy provides refined visualization of the texture of the prostate and other intrapelvic organs. Diagnostic accuracy of the transrectal scan has been successfully registered at 91% in benign prostatic hyperplasia, 85% in cancer, 89% in prostatitis, and 88% in total prostatic scans. Furthermore, prostatic calculi were visible in the tomograms of both normal and abnormal prostates at a higher frequency than generally considered. Other applications of ultrasonic control, such as during transurethral resection or cryosurgery of the prostate and staging of bladder tumors, are profitable using the gray scale technique.

Improved gray scale echograms in transrectal ultrasonography clearly can visualize the anatomical structure of and pathological changes in the prostatic gland. This study includes the classification of ultrasonic findings from the prostatic gland into acoustical pattern groups--solid, cystic and mixed--as well as into pathological-anatomical pattern groups--internal gland, external gland, nodule, stone and miscellaneous. The diagnostic accuracy of prostatic diseases using pattern analysis of prostatic inside echoes was 89 per cent, a 9 per cent improvement over that provided by conventional display.