Anal Sphincter Defects in Patients with Fecal Incontinence: Endoanal versus External Phased-Array MR Imaging

Terra, Maaike P.; Beets‐Tan, Regina G. H.; Hulst, Victor P. M. van der; Dijkgraaf, Marcel G. W.; Bossuyt, Patrick M.; Dobben, Annette C.; Baeten, C. G. M. I.; Stoker, Jaap

doi:10.1148/radiol.2363041162

Cited by 56 publications

(35 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previously, a few small single-center series or retrospective studies have shown variable interobserver reliability in characterizing specific anatomic findings of anal sphincter and pelvic structures demonstrated by using MR imaging (9)(10)(11)(12)(13)(14). Intraobserver correlation of pelvic organ prolapse has been weak even in single-site studies (12).…”

mentioning

confidence: 99%

Reproducibility of Dynamic MR Imaging Pelvic Measurements: A Multi-institutional Study

Lockhart¹,

Fielding²,

Richter³

et al. 2008

Radiology

View full text Add to dashboard Cite

Purpose:To assess the reproducibility of bone and soft-tissue pelvimetry measurements obtained from dynamic magnetic resonance (MR) imaging studies in primiparous women across multiple centers. Materials and Methods:All subjects prospectively gave consent for participation in this institutional review board-approved, HIPAA-compliant study. At six clinical sites, standardized dynamic pelvic 1.5-T multiplanar T2-weighted MR imaging was performed in three groups of primiparous women at 6 -12 months after birth: Group 1, vaginal delivery with anal sphincter tear (n ϭ 93); group 2, vaginal delivery without anal sphincter tear (n ϭ 79); and group 3, cesarean delivery without labor (n ϭ 26). After standardized central training, blinded readers at separate clinical sites and a blinded expert central reader measured nine bone and 10 soft-tissue pelvimetry parameters. Subsequently, three readers underwent additional standardized training, and reread 20 MR imaging studies. Measurement variability was assessed by using intraclass correlation for agreement between the clinical site and central readers. Acceptable agreement was defined as an intraclass correlation coefficient (ICC) of at least 0.7. Results:There was acceptable agreement (ICC range, Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article. Pelvic floor symptoms are common in women after childbirth (1). Objective assessment of anatomic changes and structural pathologic indicators is an important adjunct in characterization of pelvic floor symptoms resulting from childbirth. Dynamic magnetic resonance (MR) imaging is used to assess pelvic organ prolapse (2-5); however, correlation of MR findings with physical examination and cystocolpoproctography results is variable (5-7). Defecography also has high interobserver variability (8). Measurement reproducibility is important to assess, whether in the research or the clinical setting, since it may affect management of patients with pelvic floor disorders.Previously, a few small single-center series or retrospective studies have shown variable interobserver reliability in characterizing specific anatomic findings of anal sphincter and pelvic structures demonstrated by using MR imaging (9-14). Intraobserver correlation of pelvic organ prolapse has been weak even in single-site studies (12). Moderate and moderate-to-good interobserver correlation of external anal sphincter atrophy on endoanal ( ϭ 0.53-0.56) and phased-array coil ( ϭ 0.55-0.80) MR imaging have been reported (15). Better interobserver correlation has been shown in other singlecenter studies (10,11). Beets-Tan et al (10) showed better interobserver correlation for the internal anal sphincter by using endoanal (intraclass correlation coefficient [ICC], 0.65) and phasedarray (ICC, 0.75) MR imaging. Keller et al (11) showed high interobserver correlation for bone measurements such as obstetric conjugate (ICC, 0.96...

show abstract

mentioning

confidence: 99%

Reproducibility of Dynamic MR Imaging Pelvic Measurements: A Multi-institutional Study

Lockhart¹,

Fielding²,

Richter³

et al. 2008

Radiology

View full text Add to dashboard Cite

show abstract

“…Two recent studies in 30 patients with faecal incontinence have shown that this technique, despite its inferior local spatial resolution, is comparable with endoanal MR imaging for the depiction of anal sphincter defects and EAS atrophy (Fig. 8) [68,69]. The interobserver agreement for assessing anal sphincter integrity is moderate for endoanal MR imaging and poor to fair for external phased array MR imaging [69,70].…”

Section: Mr Imagingmentioning

confidence: 93%

“…The interobserver agreement for assessing anal sphincter integrity is moderate for endoanal MR imaging and poor to fair for external phased array MR imaging [69,70]. The intraobserver agreement for detecting anal sphincter defects ranged from fair to very good for endoanal MR imaging and external phased array MR imaging [69]. Only one study evaluated the observer reproducibility in assessing EAS atrophy with MR imaging and reported that the interobserver agreement was moderate for endoanal MR imaging and moderate to good for external phased array MR imaging [68].…”

Section: Mr Imagingmentioning

confidence: 98%

See 1 more Smart Citation

The current role of imaging techniques in faecal incontinence

Terra

Stoker

2006

Eur Radiol

View full text Add to dashboard Cite

Faecal incontinence is a common multifactorial disorder. Major causes of faecal incontinence are related to vaginal delivery and prior anorectal surgery. In addition to medical history and physical examination, several anorectal functional tests and imaging techniques can be used to assess the underlying pathophysiology and to guide treatment planning in faecal incontinent patients. Anorectal functional tests provide functional information, but the potential strength comes from combining test results. Imaging techniques, including defecography, endoanal sonography, and magnetic resonance (MR) imaging, provide structural information about the anorectal region with a direct clinical impact. The major role of imaging techniques in faecal incontinence is visualising the structural and functional integrity of the anal sphincter complex. Both two-dimensional endoanal sonography and endoanal MR imaging are accurate tools to depict anal sphincter defects. The major advantage of endoanal MR imaging is the accurate demonstration of external anal sphincter atrophy. Recent studies have suggested that external phased array MR imaging and three-dimensional endoanal sonography are also valuable tools in the diagnostic work up of faecal incontinence. Decisions about the preferred technique will mainly be determined by availability and local expertise. This article demonstrates the current role of tests, predominantly imaging tests, in the diagnostic work up of faecal incontinence.

show abstract

“…Geht es um die Darstellung ausgedehnter Tumoren, hat die "phased array MRT" den Vorteil eines größe-ren Gesichtsfeldes. In der Beurteilung des Schließmuskelapparates (M. sphincter ani externus und internus) hingegen unterscheiden sich beide Formen der Magnetresonanztomographie nicht signifikant voneinander, wie in einer prospektiven Vergleichsstudie an 30 Patienten mit fäkaler Inkontinenz gezeigt werden konnte [50]. Die Methode setzt jedoch große Erfahrung voraus und sollte deshalb nur an Zentren mit der entsprechenden Expertise durchgeführt werden.…”

Section: Magnetresonanztomographieunclassified

Fortschritte in der Diagnostik anorektaler Erkrankungen

Bouchard

Lubienski

et al. 2008

Chirurg

View full text Add to dashboard Cite

Diagnostics and therapy of anorectal disorders remain a surgical question. In close cooperation between different departments (radiology and gastroenterology, urology and gynecology, dermatology and psychology), the role of radiologic imaging is of growing importance. Exact knowledge of functional anatomy and precise clinical examination constitute the basis of the according therapeutic strategies. In this context radiology has contributed decisively. Developments in imaging techniques, e.g. dynamic MRI, highly contributed to better understanding of complex functional pelvic floor disorders. The combination of nanotechnology and high-resolution imaging allows precise staging, especially in rectal cancer. Furthermore, advances in virtual colonoscopy could lead to widely acceptable and patient-friendly screening for colorectal malignancies.

show abstract

Anal Sphincter Defects in Patients with Fecal Incontinence: Endoanal versus External Phased-Array MR Imaging

Cited by 56 publications

References 44 publications

Reproducibility of Dynamic MR Imaging Pelvic Measurements: A Multi-institutional Study

Reproducibility of Dynamic MR Imaging Pelvic Measurements: A Multi-institutional Study

The current role of imaging techniques in faecal incontinence

Fortschritte in der Diagnostik anorektaler Erkrankungen

Contact Info

Product

Resources

About