Accuracy of integrated total pelvic floor ultrasound compared to defaecatory MRI in females with pelvic floor defaecatory dysfunction
Accuracy of integrated total pelvic floor ultrasound compared to defaecatory MRI in females with pelvic floor defaecatory dysfunction
OBJECTIVE: Defaecatory MRI allows multicompartmental assessment of defaecatory dysfunction but is often inaccessible. Integrated total pelvic floor ultrasound (transperineal, transvaginal, endoanal) may provide a cheap, portable alternative. The accuracy of total pelvic floor ultrasound for anatomical abnormalities when compared with defaecatory MRI was assessed.
METHODS: The dynamic images from 68 females who had undergone integrated total pelvic floor ultrasound and defaecatory MRI between 2009 and 2015 were blindly reviewed. The following were recorded: rectocoele, enterocoele, intussusception and cystocoele.
RESULTS: There were 26 rectocoeles on MRI (49 rectocoeles on ultrasound), 24 rectocoeles with intussusception on MRI (19 rectocoeles on ultrasound), 23 enterocoeles on MRI (24 enterocoeles on ultrasound) and 49 cystocoeles on MRI (35 cystocoeles on ultrasound). Sensitivity and specificity of total pelvic floor ultrasound were 81% and 33% for rectocoele, 60% and 91% for intussusception, 65% and 80% for enterocoele and 65% and 84% for cystocoele when compared with defaecatory MRI. This gave a negative-predictive value and positive-predictive value of 74% and 43% for rectocoele, 80% and 79% for intussusception, 82% and 63% for enterocoele and 48% and 91% for cystocoele.
CONCLUSION: Integrated total pelvic floor ultrasound may serve as a screening tool for pelvic floor defaecatory dysfunction; when normal, defaecatory MRI can be avoided, as rectocoele, intussusception and enterocoele are unlikely to be present. Advances in knowledge: This is the first study to compare integrated total pelvic floor ultrasound with defaecatory MRI. The results support the use of integrated total pelvic floor ultrasound as a screening tool for defaecatory dysfunction.
Adult, Aged, Aged, 80 and over, Defecation/physiology, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Pelvic Floor/diagnostic imaging, Pelvic Floor Disorders/diagnostic imaging, Reproducibility of Results, Retrospective Studies, Ultrasonography, Young Adult
1-8
Hainsworth, Alison J.
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Pilkington, Sophie A.
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Grierson, Catherine
db17e433-591a-4865-8e3f-9326c2962da7
Rutherford, Elizabeth
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Schizas, Alexis M.P.
fd1e74f0-2c7d-4683-aaca-3cba3626e7c4
Nugent, Karen
79fcb89d-6ff2-47b8-ac2c-2afb24954456
Williams, Andrew B.
2f0fcd21-285f-47ec-b59c-42a9a64bd8e1
December 2016
Hainsworth, Alison J.
8a0be4d3-a51c-4f91-9cbc-96d527c65a30
Pilkington, Sophie A.
af7c9330-5153-43e4-ab8a-80221c6c74be
Grierson, Catherine
db17e433-591a-4865-8e3f-9326c2962da7
Rutherford, Elizabeth
f619b2cb-a503-4f3d-aabb-1d26a306bdab
Schizas, Alexis M.P.
fd1e74f0-2c7d-4683-aaca-3cba3626e7c4
Nugent, Karen
79fcb89d-6ff2-47b8-ac2c-2afb24954456
Williams, Andrew B.
2f0fcd21-285f-47ec-b59c-42a9a64bd8e1
Hainsworth, Alison J., Pilkington, Sophie A., Grierson, Catherine, Rutherford, Elizabeth, Schizas, Alexis M.P., Nugent, Karen and Williams, Andrew B.
(2016)
Accuracy of integrated total pelvic floor ultrasound compared to defaecatory MRI in females with pelvic floor defaecatory dysfunction.
British Journal of Radiology, 89 (1068), , [20160522].
(doi:10.1259/bjr.20160522).
Abstract
OBJECTIVE: Defaecatory MRI allows multicompartmental assessment of defaecatory dysfunction but is often inaccessible. Integrated total pelvic floor ultrasound (transperineal, transvaginal, endoanal) may provide a cheap, portable alternative. The accuracy of total pelvic floor ultrasound for anatomical abnormalities when compared with defaecatory MRI was assessed.
METHODS: The dynamic images from 68 females who had undergone integrated total pelvic floor ultrasound and defaecatory MRI between 2009 and 2015 were blindly reviewed. The following were recorded: rectocoele, enterocoele, intussusception and cystocoele.
RESULTS: There were 26 rectocoeles on MRI (49 rectocoeles on ultrasound), 24 rectocoeles with intussusception on MRI (19 rectocoeles on ultrasound), 23 enterocoeles on MRI (24 enterocoeles on ultrasound) and 49 cystocoeles on MRI (35 cystocoeles on ultrasound). Sensitivity and specificity of total pelvic floor ultrasound were 81% and 33% for rectocoele, 60% and 91% for intussusception, 65% and 80% for enterocoele and 65% and 84% for cystocoele when compared with defaecatory MRI. This gave a negative-predictive value and positive-predictive value of 74% and 43% for rectocoele, 80% and 79% for intussusception, 82% and 63% for enterocoele and 48% and 91% for cystocoele.
CONCLUSION: Integrated total pelvic floor ultrasound may serve as a screening tool for pelvic floor defaecatory dysfunction; when normal, defaecatory MRI can be avoided, as rectocoele, intussusception and enterocoele are unlikely to be present. Advances in knowledge: This is the first study to compare integrated total pelvic floor ultrasound with defaecatory MRI. The results support the use of integrated total pelvic floor ultrasound as a screening tool for defaecatory dysfunction.
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Accepted/In Press date: 10 October 2016
e-pub ahead of print date: 18 November 2016
Published date: December 2016
Keywords:
Adult, Aged, Aged, 80 and over, Defecation/physiology, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Pelvic Floor/diagnostic imaging, Pelvic Floor Disorders/diagnostic imaging, Reproducibility of Results, Retrospective Studies, Ultrasonography, Young Adult
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Local EPrints ID: 443279
URI: http://eprints.soton.ac.uk/id/eprint/443279
ISSN: 0007-1285
PURE UUID: 0c1fbef6-be33-46d8-96ab-a499df25a320
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Date deposited: 19 Aug 2020 16:33
Last modified: 16 Mar 2024 09:00
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Author:
Alison J. Hainsworth
Author:
Sophie A. Pilkington
Author:
Catherine Grierson
Author:
Elizabeth Rutherford
Author:
Alexis M.P. Schizas
Author:
Andrew B. Williams
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