Accuracy of integrated total pelvic floor ultrasound compared to defaecatory MRI in females with pelvic floor defaecatory dysfunction

Abstract

Cite this article as:Hainsworth AJ, Pilkington SA, Grierson C, Rutherford E, Schizas AMP, Nugent KP, et al. Accuracy of integrated total pelvic floor ultrasound compared to defaecatory MRI in females with pelvic floor defaecatory dysfunction. Objective: Defaecatory MRI allows multicompartmental assessment of defaecatory dysfunction but is often inaccessible. Integrated total pelvic floor ultrasound (transperineal, transvaginal, endoanal) may provide a cheap, portable alternative. The accuracy of total pelvic floor ultrasound for anatomical abnormalities when compared with defaecatory MRI was assessed. Methods: The dynamic images from 68 females who had undergone integrated total pelvic floor ultrasound and defaecatory MRI between 2009 and 2015 were blindly reviewed. The following were recorded: rectocoele, enterocoele, intussusception and cystocoele. Results: There were 26 rectocoeles on MRI (49 rectocoeles on ultrasound), 24 rectocoeles with intussusception on MRI (19 rectocoeles on ultrasound), 23 enterocoeles on MRI (24 enterocoeles on ultrasound) and 49 cystocoeles on MRI (35 cystocoeles on ultrasound). Sensitivity and specificity of total pelvic floor ultrasound were 81% and 33% for rectocoele, 60% and 91% for intussusception, 65% and 80% for enterocoele and 65% and 84% for cystocoele when compared with defaecatory MRI. This gave a negativepredictive value and positive-predictive value of 74% and 43% for rectocoele, 80% and 79% for intussusception, 82% and 63% for enterocoele and 48% and 91% for cystocoele. Conclusion: Integrated total pelvic floor ultrasound may serve as a screening tool for pelvic floor defaecatory dysfunction; when normal, defaecatory MRI can be avoided, as rectocoele, intussusception and enterocoele are unlikely to be present. Advances in knowledge: This is the first study to compare integrated total pelvic floor ultrasound with defaecatory MRI. The results support the use of integrated total pelvic floor ultrasound as a screening tool for defaecatory dysfunction.

Pelvic floor muscles after prostate radiation therapy: morpho-functional assessment by magnetic resonance imaging, surface electromyography and digital anal palpation

“…The accuracy of total pelvic floor ultrasound for anatomical abnormalities when compared with defecatory MRI was assessed by Hainsworth at al. (14). They found that sensitivity and specificity of total pelvic floor ultrasound were 81% and 33% for rectocele, 60% and 91% for intussusception, 65% and 80% for enterocele and 65% and 84% for cystocele when compared with defecatory MRI.…”

Sonographic Association of Endometrial Thickness at Proliferative Phase in Infertile Females

“…The reliability of transvaginal as well as trans abdominal sonographic is within clinically acceptable limits 23 . With the developments of the machines and introduction of the high-resolution transducer in state of the art modalities, improved the accuracy of ultrasound in the measurement of endometrium 24 .…”

Beyond Imagination: Integrated Imaging Approach to Pelvic Floor Disorders

“…Imaging plays an important role to go beyond imagination. It provides a better understanding of the pathophysiology of PFD, visualizing abnormalities undetected by the clinicians and/or confirming clinical findings to correlate with symptoms [12][13][14][15]. Although, in recent years, new techniques have been dramatically improved the diagnostic accuracy in patients with PFD, there is still no single modality than can provide a comprehensive overview of the PF.…”

“…They found no superiority of 4D over dynamic 2D US and concluded that these two techniques could be used interchangeably to screen women with ODS. Hainsworth et al [14] compared the accuracy of integrated total PFUS (transperineal, transvaginal, endoanal) to defaecatory MR. The results supported the use of integrated US as a screening tool for defaecatory dysfunction.…”