In the last 20 years, endorectal ultrasound (ERUS) has been one of the main diagnostic methods for locoregional staging of rectal cancer. ERUS is accurate modality for evaluating local invasion of rectal carcinoma into the rectal wall layers (T category). Adding the three-dimensional modality (3-D) increases the capabilities of this diagnostic tool in rectal cancer patients. We review the literature and report our experience in preoperative 3-D ERUS in rectal cancer staging. In the group of 71 patients, the staging of preoperative 3-D endorectal ultrasonography was compared with the postoperative morphologic examination. Three-dimensional ERUS preoperative staging was confirmed with morphologic evaluation in 66 out of 71 cases (92.9%). The detection sensitivities of rectal cancer with 3-D ERUS were as follows: T1, 92.8%; T2, 93.1%; T3, 91.6%; and T4, 100.0%; with specificity values of T1, 98.2%; T2, 95.4%; T3, 97.8%; and T4, 98.5%. Three-dimensional ERUS correctly categorized patients with T1, 97.1%; T2, 94.3%; T3, 95.7%; and T4, 98.5%. The percentage of total overstaged cases was 2.75% and that of understaged cases was 6.87%. The metastatic status of the lymph nodes was determined with a sensitivity of 79.1% (19 of 24), specificity of 91.4% (43 of 47), and diagnostic accuracy of 87.3% (62 of 71). In our experience, 3-D ERUS has the potential to become the diagnostic modality of choice for the preoperative staging of rectal cancer.

malignant pathology and by obtaining more tissue sampling and/or a second opinion from a consulting pathologist in none diagnostic, highly suspected colon lesion. Besides the role as a diagnostic tool in CRC, colonoscopy identifies subsequent lesions at the time of surgery, which is called preoperative endoscopic marking. It is performed through metallic clip placement and endoscopic tattooing. The colonoscopic equipment consists of camera and four-way tip controls [43]. The camera can produce images of high-definition quality. The four way tip controls include (1) examination of a found patch to confirm an abnormal growth; (2) insufflating air to dilate the lumen for mucosal inspection and relieving air after examination, (3) irrigating a suspected region; (4) suctioning to avoid missing lesions under fluid, and (5) inserting biopsy devices. The patient must undergo bowel preparation-taking clear liquid diet and ingesting laxative solutions for colon cleansing the day before examination. Sedation is needed to relieve the discomfort during the procedure, but it increases the costs. The complication of sedation are different cardiac disturbances such as hypotension, arrhythmias,oxygen desaturation, and others. The preparation with purgatives may cause abdominal discomfort, nausea, and other symptoms. The colonoscopy continues from 30 minutes to an hour. The risk during colonoscopy consists in colonic perforation in 0,1 % of cases. Colonoscopy fails to visualize the entire colon in 10-15% and it may miss up to 10-20% of polyps fewer than 10 mm. Colonoscopy is golden standard for diagnosing of CRC but there are more symptoms which could be evaluated and appreciated by endoscopic examination, for example-abdominal pain, unexplained gastrointestinal bleeding, diarrhea of unexplained origin, chronic inflammatory bowel disease, etc. It is also the most common interventional modality for polypectomy, hemostasis, balloon dilation, foreign body removal, palliative treatment of neoplasms, etc. Colonoscopy could be the best screening option for all none specific underdiagnosed gastrointestinal symptoms. Colonoscopy removes all detected polyps, regardless of histology type-adenomatous or hyperplastic. Not all of them must undergo resection. The polyps vary in size and polyps under 5 mm are not detected endoscopic. For detection of polyps smaller than 5 mm the virtual colonospcopy is the alternative to the conventional colonoscopy.

E. granulosis is the species that prevails in most countries around the world and especially in the Mediterranean region. It is one of the most severe infestations in humans. The biological diagnosis is based on serological tests. Eosinophilia is considered variable because it does occur in cases of a hydatid cyst disease but its absence does not exclude the possibility of a hydatid cyst existence. Imaging diagnostics are important for the classification of the hydatid cysts. Ultrasound is a noninvasive, widely available method with high sensitivity to the diagnosis of hepatic echinococcosis and of low price, therefore it is a method of choice. CT is the method of doubt for a suppuration of a hydatid cyst. An MRI with high contrast resolution of T1 and T2 images demonstrated better pericyst , daughter cysts and matrix. We have reviewed the current trends in the diagnosis of liver cystic echinococcosis.

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