HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dobben, A. C. Articles by Stoker, J. Search for Related Content PubMed PubMed Citation Articles by Dobben, A. C. Articles by Stoker, J.

External Anal Sphincter Defects in Patients with Fecal Incontinence: Comparison of Endoanal MR Imaging and Endoanal US¹

¹ From the Departments of Radiology (A.C.D., M.P.T., J.S.), Surgery (J.F.M.S.), and Clinical Epidemiology and Biostatistics (M.D., P.M.M.B.), Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (M.F.G.); and Department of Radiology, University Hospital Maastricht, Maastricht, the Netherlands (R.G.H.B.). Received September 21, 2005; revision requested November 14; revision received January 31, 2006; accepted March 3; final version accepted May 3. Supported by the Netherlands Organization for Health Research and Development ZON MW (grant 945-01-013). Address correspondence to A.C.D. (e-mail: a.c.dobben{at}amc.uva.nl).

Purpose: To prospectively compare in a multicenter study the agreement between endoanal magnetic resonance (MR) imaging and endoanal ultrasonography (US) in depicting external anal sphincter (EAS) defects in patients with fecal incontinence.

Materials and Methods: The study was approved by the medical ethics committee of all participating centers. A total of 237 consenting patients (214 women, 23 men; mean age, 58.6 years ± 13 [standard deviation]) with fecal incontinence were examined from 13 different hospitals by using endoanal MR imaging and endoanal US. Patients with an anterior EAS defect depicted on endoanal MR images and/or endoanal US scans underwent anal sphincter repair. Surgical findings were used as the reference standard in the determination of anterior EAS defects. The Cohen statistic and McNemar test were used to calculate agreement and differences between diagnostic techniques.

Results: Agreement between endoanal MR imaging and endoanal US was fair for the depiction of sphincter defects ( = 0.24 [95% confidence interval: 0.12, 0.36]). At surgery, EAS defects were found in 31 (86%) of 36 patients. There was no significant difference between MR imaging and US in the depiction of sphincter defects (P = .23). Sensitivity and positive predictive value were 81% and 89%, respectively, for endoanal MR imaging and 90% and 85%, respectively, for endoanal US.

Conclusion: In the selection of patients for anal sphincter repair, both endoanal MR imaging and endoanal US are sensitive tools for preoperative assessment, and both techniques can be used to depict surgically repairable anterior EAS defects.

© RSNA, 2007

This article has been cited by other articles:

				A. C. Dobben, R. J. F. Felt-Bersma, F. J. W. ten Kate, and J. Stoker Cross-Sectional Imaging of the Anal Sphincter in Fecal Incontinence Am. J. Roentgenol., March 1, 2008; 190(3): 671 - 682. [Abstract] [Full Text] [PDF]

				F. Berton, G. Gola, and S. R. Wilson Sonography of Benign Conditions of the Anal Canal: An Update Am. J. Roentgenol., October 1, 2007; 189(4): 765 - 773. [Abstract] [Full Text] [PDF]

				A. C. Dobben, M. P. Terra, M. Deutekom, J. F. M. Slors, L. W. M. Janssen, P. M. M. Bossuyt, and J. Stoker The Role of Endoluminal Imaging in Clinical Outcome of Overlapping Anterior Anal Sphincter Repair in Patients with Fecal Incontinence Am. J. Roentgenol., August 1, 2007; 189(2): W70 - W77. [Abstract] [Full Text] [PDF]