Fecal incontinence: endoanal US versus endoanal MR imaging.
OBJECTIVE
To assess endoanal ultrasonography (US) and endoanal magnetic resonance (MR) imaging for mapping of anal sphincter defects that have been validated at surgery in patients with fecal incontinence.


METHODS
US, MR imaging, and surgical findings in 22 women with fecal incontinence who underwent sphincter repair were retrospectively reviewed. US and MR imaging had been performed before surgery. The findings were evaluated separately and validated with surgical results.


RESULTS
Endoanal MR imaging findings showed better agreement with surgical results than did endoanal US findings for diagnosis of lesions of the external sphincter (kappa value, 0.85 vs 0.53) and of the internal sphincter (kappa value, 0.64 vs 0.49). Endoanal US could not accurately demonstrate thinning of the external sphincter. MR imaging results correlated moderately with US results (kappa = 0.39). If endoanal MR images alone had been considered, the correct surgical decision would have been made in 21 (95%) patients; if endoanal US images alone had been considered, the correct decision would have been made in 17 (77%) patients.


CONCLUSIONS
MR imaging is more accurate than US for demonstration of sphincter lesions. MR imaging provides higher spatial resolution and better inherent image contrast for lesion characterization. Endoanal MR imaging allows more precise description of the extent and structure of complex lesions and is superior for help in decisions about optimal therapy.
Rociu
E
E
Department of Radiology, University Hospital Rotterdam, The Netherlands.
Stoker
J
J
Eijkemans
M J
MJ
Schouten
W R
WR
Laméris
J S
JS
D001003:Anal Canal / Q000000981:diagnostic imaging / Q000473:pathology; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014463:Ultrasonography / Q000379:methods