Measuring the anorectal angle

Hero, Marc; Arhan, Pierre; Devroede, Ghislain; Jehannin, B; Faverdin, C; Babin, Claude; Pellerin, D

doi:10.1016/0141-5425(85)90063-9

Journal of Biomedical Engineering

1985

DOI: 10.1016/0141-5425(85)90063-9

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Measuring the anorectal angle

Marc Hero

Pierre Arhan

Ghislain Devroede

et al.

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Cited by 7 publications

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“…Defecography above mentioned is a very useful radiological technique for evaluating the size of the rectum and the modifications of the rectoanal angle during pel-vic muscular contraction, evacuation of the baryta by comparison with rest (12).…”

mentioning

confidence: 99%

Physiological Assessment of Rectoanal Motor Function

Arhan

2002

J. pediatr. gastroenterol. nutr.

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mentioning

confidence: 99%

Physiological Assessment of Rectoanal Motor Function

Arhan

2002

J. pediatr. gastroenterol. nutr.

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Observer variation in the radiological measurement of the anorectal angle

et al. 1990

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Determination of the anorectal angle (ARA) and the position of the pelvic floor is, theoretically, very important in understanding the mechanisms of anorectal continence and defaecation. The variability in the measurement of the ARA was analyzed. Nine experts drew ther rectal axis either as a line along the posterior wall of the distal rectum or as the central axis of the rectal lumen on the outlines of 18 representative proctographic images. The standard deviations and ranges of the mean values of each ARA were comparable but large in both methods. On average, the S.D. was 8 degrees and the range value about 23 degrees. Inter-observer variation was not related to the magnitude of the ARA, but rather to the anorectal configuration. Drawing a line along the posterior distal rectal wall is difficult when it is irregular or when the puborectalis impression is indistinct. The central rectal axis is difficult to draw when the junction between the upper and lower rectum is ill defined or when the outlines of the distal rectum are asymmetric e.g. by the presence of a rectocele. Thus, the variability of both methods was not strongly interrelated (r = 0.68 for the median values). It is concluded that, in general, radiologic assessment of the ARA is not reliable enough for comparative investigation of the dynamics of the anorectum.

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Intraobserver variation in the radiological measurement of the anorectal angle

Penninckx

Debruyne

Lestár

et al. 1991

Gastrointest Radiol

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Seven experts drew the rectal axes of 18 representative proctographic images on two occasions, with a 1-year interval, in order to assess intraobserver variation in the determination of the anorectal angle (ARA). Intraobserver variation (6%) and interobserver variation (17%) were smallest when the central rectal axis was used to determine the ARA. A strong relation was found between inter- and intraobserver variation (r = 0.77). Intraobserver variation tended to be rather small for pictures made during straining, but a relation with the magnitude of the ARA was not found. Although none of the seven experts could reproduce the rectal axes with less than or equal to 10% variation in all 18 pictures, redrawing of the central rectal axis delivered less than or equal to 10% variation in 86% of determinations. It is concluded that intraobserver variation is influenced by the expertise of the investigator, the method of analysis, and the anorectal configuration to be analyzed. Radiologic assessment of the ARA may yield reliable data on the dynamics of the anorectum if performed by a single investigator on x-ray films that allow confident analysis.

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Measuring the anorectal angle

Cited by 7 publications

References 4 publications

Physiological Assessment of Rectoanal Motor Function

Physiological Assessment of Rectoanal Motor Function

Observer variation in the radiological measurement of the anorectal angle

Intraobserver variation in the radiological measurement of the anorectal angle

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