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Measurement of Anal Sphincter Muscles: Endoanal US, Endoanal MR Imaging, or Phased-Array MR Imaging? A Study with Healthy Volunteers¹

¹ From the Departments of Radiology (R.G.H.B.T., E.L., J.M.A.v.E.), Surgery (G.L.M., G.L.B., K.e.N., C.G.M.I.B.), and Clinical Epidemiology (A.G.H.K.), University Hospital of Maastricht, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands. Received April 24, 2000; revision requested May 25; final revision received October 10; accepted November 1. Address correspondence to R.G.H.B.T. (e-mail: rbe@rdia.azm.nl).

PURPOSE: To compare endoanal ultrasonography (US), endoanal magnetic resonance (MR) imaging, and phased-array MR imaging for anal sphincter muscle measurement.

MATERIALS AND METHODS: Sixty healthy volunteers underwent 1.5-T phased-array MR, endoanal MR, and endoanal US examinations. Sphincter muscle thicknesses were measured. Measurement reliability was analyzed, and correlations among the imaging methods were calculated. Multivariate analysis was performed to assess the influence of age, weight, height, sex, parity, and obstetric trauma on sphincter dimensions.

RESULTS: Both MR methods had good reliability for measurements of all sphincter components, whereas endoanal US was reliable for internal sphincter measurement only. There was little correlation between the techniques, except between the two MR techniques, with a strong correlation for total sphincter and perineal body thickness. The internal sphincter thickened significantly (P = .002) with age at endoanal US and endoanal MR imaging but not at phased-array MR imaging. There were small sex-based differences in sphincter muscle measurements at phased-array MR imaging only.

CONCLUSION: Endoanal US enables reliable measurement of only internal sphincter thickness, whereas both MR imaging methods enable reliable measurement of all sphincter components. Sphincter measurement with phased-array MR imaging is as reliable as that with endoanal MR imaging.

Index terms: Anus, 757.92 • Anus, MR, 757.121411, 757.121412, 757.121416 • Anus, US, 757.12989 • Magnetic resonance (MR), comparative studies, 757.121411, 757.121416

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