Exo-anal imaging of the anal sphincter: a comparison between introital and transperineal image acquisition.
Int Urogynecol J
; 31(6): 1107-1113, 2020 06.
Article
em En
| MEDLINE
| ID: mdl-31802159
ABSTRACT
INTRODUCTION AND HYPOTHESIS:
Three-dimensional exoanal ultrasound imaging of the anal sphincter may be obtained transperineally with a convex probe, or at the introitus with a transvaginal probe. We hypothesised that introital acquisition would yield better quality and more reproducible evaluation.METHODS:
We acquired three 3D volumes of the anal sphincter (one transperineal transverse with a 4- to 8-MHz convex probe and two introital with a 5- to 9-MHz probe in transverse and mid-sagittal view) in 20 representative women attending the gynaecology clinic. Each 3D dataset was anonymised and hence blinded for clinical data and for acquisition method. Images were analysed off-line by two expert specifically trained ultrasonographers in a random order to assess image quality, sphincter integrity and sphincteric measurements. We assessed the intra- and interrater agreement by the Cohen's kappa (κ) and by the intraclass correlation coefficient for categorical and continuous variables respectively.RESULTS:
The mid-sagittal introital acquisition had most inconclusive images owing to unsatisfactory quality, on which raters agreed (Ð = 0.80). Subsequently, agreement in the anal sphincter evaluation between transverse introital and transperineal acquisitions was compared. Agreement on internal anal sphincter gap was excellent for both transverse introital (Ð = 0.87) and transperineal acquisition (Ð = 0.93). Agreement on external anal sphincter discontinuity was excellent for the transperineal acquisition (Ð = 0.87) and good for the transverse introital acquisition (Ð = 0.73). Intra- and interrater agreement of external and internal anal sphincteric measurements were best for transperineal acquisitions.CONCLUSIONS:
In our hands, transperineal acquisition with a 4- to 8-MHz probe performed better than introital acquisition with a 5- to 9-MHz probe in the assessment of the anal sphincter complex.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Canal Anal
/
Vagina
Tipo de estudo:
Diagnostic_studies
Limite:
Female
/
Humans
Idioma:
En
Revista:
Int Urogynecol J
Ano de publicação:
2020
Tipo de documento:
Article