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Colorectal Dis ; 11(8): 872-7, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19681980

ABSTRACT

OBJECTIVE: The aim of this prospective study was to test two-dimensional dynamic anorectal ultrasonography (2D-DAUS) in the assessment of anismus and compare it with echodefecography (ECD). METHOD: Fifty consecutive female patients with outlet delay were submitted to 2D and 3D-DAUS, measuring the relaxing or contracting puborectalis muscle angle during straining. The patients were assigned to one of two groups based on ECD findings. Group I consisted of 29 patients without anismus and group II included 21 patients diagnosed with anismus. Subsequently 2D-DAUS images were checked for anismus and compared with ECD findings. RESULTS: Upon straining, the angle produced by the movement of the puborectalis muscle decreased in 26 out of the 29 (89.6%) patients of group I and increased 19 out of the 21 (90.4%) patients of group II. The mean angle during straining differed significantly between group I and group II. The index of agreement between the two scanning modes was 89.6% (26/29) for group I (Kappa: 0.796; CI: 95%; range: 0.51-1.0) and 90.4% (19/21) for group II (Kappa: 0.796; CI: 95%; range: 0.51-1.0). CONCLUSION: Two-dimensional dynamic anal ultrasonography can be used as an alternative method to assess patients with anismus, although the 3-D modality is more precise to evaluate the PR angle as the sphincters integrity as the whole muscle length is clearly visualized.


Subject(s)
Anal Canal/diagnostic imaging , Anus Diseases/diagnostic imaging , Endosonography/methods , Pelvic Floor/diagnostic imaging , Adult , Aged , Aged, 80 and over , Ataxia/diagnosis , Constipation/diagnostic imaging , Female , Humans , Imaging, Three-Dimensional , Middle Aged , Young Adult
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