直肠神经内分泌肿瘤(R-NENs)是一种少见但具有潜在恶性的肿瘤，起源于肠道中的神经内分泌细胞。近年来检出率逐渐升高，其早期诊断和治疗策略选择对预后具有重要意义。微探头超声内镜(MEUS)作为一种高分辨率成像技术，在R-NENs的诊疗过程中发挥着关键作用。MEUS可精准评估肿瘤大小、浸润深度、起源层次及区域淋巴结状态，为制定内镜或外科治疗方案提供关键依据。在鉴别诊断方面，MEUS能够通过分析病变的回声特征及其与肠壁层次结构的关系，有效区分R-NENs与其他黏膜下病变。尽管MEUS在微小病灶检出、淋巴结评估及深部浸润判断方面仍存在一定局限，但随着超高频探头、多模态成像和人工智能辅助技术的发展，正为其在R-NENs精准诊疗领域开辟更广阔的应用前景。本文综述了MEUS在R-NENs诊断、术前评估及未来发展方向中的现状与挑战。

Rectal neuroendocrine neoplasms (R-NENs) are rare but potentially malignant neoplasms originating from neuroendocrine cells within the intestinal tract.Their detection rate has gradually increased in recent years, making early diagnosis and therapeutic strategy selection crucial for prognosis.As a high-resolution imaging technique, miniprobe endoscopic ultrasound(MEUS) plays a pivotal role in the diagnosis and management of R-NENs.It enables precise assessment of tumor size, depth of invasion, origin layer, and regional lymph node status, providing critical guidance for formulating endoscopic or surgical treatment plans.In differential diagnosis, MEUS effectively distinguishes R-NENs from other submucosal lesions by analyzing lesion echogenicity and its relationship with intestinal wall layers.Although MEUS still has limitations in detecting minute lesions, assessing lymph nodes, and judging deep infiltration, the development of ultra-high-frequency probes, multimodal imaging, and AI-assisted technologies is opening broader application prospects for its precise diagnosis and treatment of R-NENs.This article reviews the current status and challenges of MEUS in the diagnosis, preoperative assessment, and future development of R-NENs.