Department of Surgery B, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Colorectal Dis. 2009 Nov;11(9):933-40. doi: 10.1111/j.1463-1318.2008.01730.x. Epub 2008 Oct 31.
The main application of endoanal ultrasonography (US) in evaluation of faecal incontinence is to identify surgically correctable sphincter defects. The aim of our study was to determine whether qualitative changes in echogenicity and in uniformity of internal (IAS) and external (EAS) anal sphincter muscles detected on endoanal US correlate with other anal laboratory tests and modified Wexner faecal incontinence functional score.
Records on 99 patients having complete information on anorectal manometry, faecal incontinence scoring and available endoanal US imaging of the anal sphincters were included in statistical analysis. Anatomic appearance and changes in echogenicity of the anal sphincter muscles were recorded according to the proposed scoring system. Endoanal US defect and quality component scores for IAS and EAS as well as the total score were correlated with anal laboratory tests and incontinence score using Spearman's correlations test.
There was a trend for correlation between IAS quality score and incontinence score (P = 0.06), but no correlation for IAS defect score. EAS defect score had a significant negative correlation with maximum squeeze pressure (MSP) (P = 0.031). Distal EAS quality score had a significant correlation with incontinence score (P = 0.002). EAS total score correlated with MSP (P = 0.02) and incontinence score (P = 0.006). Endoanal US total score was significantly correlated with incontinence score (P = 0.006), maximal resting (MRP) (P = 0.035) and MSP (P = 0.045) and high pressure anal canal zone length (P = 0.03).
Sonographic morphology of anal sphincter muscles correlates with anal laboratory tests and functional incontinence score. Qualitative ultrasound scoring instrument may improve evaluation of patients with faecal incontinence.
经肛门超声（endoanal ultrasonography，EUS）在评估粪便失禁中的主要应用是识别可通过手术矫正的括约肌缺陷。本研究旨在确定 EUS 检测到的内部（IAS）和外部（EAS）肛门括约肌的回声强度和均匀性的定性变化是否与其他肛门实验室检查和改良 Wexner 粪便失禁功能评分相关。
纳入了 99 例具有完整肛门测压、粪便失禁评分和可利用的肛门括约肌 EUS 成像记录的患者进行统计分析。根据提出的评分系统记录肛门括约肌的解剖外观和回声强度变化。EUS 检测到的 IAS 和 EAS 的缺陷和质量成分评分以及总评分与肛门实验室检查和失禁评分相关，采用 Spearman 相关检验。
IAS 质量评分与失禁评分呈显著相关（P = 0.06），但 IAS 缺陷评分无显著相关性。EAS 缺陷评分与最大收缩压（MSP）有显著负相关（P = 0.031）。远端 EAS 质量评分与失禁评分有显著相关性（P = 0.002）。EAS 总评分与 MSP（P = 0.02）和失禁评分（P = 0.006）相关。EUS 总评分与失禁评分（P = 0.006）、最大静息压（MRP）（P = 0.035）和 MSP（P = 0.045）和高压肛门管区长度（P = 0.03）有显著相关性。
肛门括约肌的超声形态与肛门实验室检查和功能性失禁评分相关。定性超声评分工具可能会改善对粪便失禁患者的评估。
